Abstract
The NCCN guideline and the MASCC/ESMO guideline define high-dose cisplatin (CDDP≧50mg/m2) as highly emetologenic chemotherapy, and recommend the use of an aprepitant. According to the guidelines, we performed radiation plus concurrent weekly cisplatin (CDDP: 40mg/m2) (weekly CDDP+RT) without prophylactic aprepitant in outpatient chemotherapy. We evaluated incidence of nausea and vomiting in the weekly CDDP+RT regimen retrospectively. The subjects included 42 head and neck cancer patients who received a weekly CDDP+RT chemotherapy regimen between September 2009 and December 2011. We investigated the rate of completion of the chemotherapy without aprepitant and worst nausea grade through the course of the chemotherapy regimen. The median age of the patients was 60 years old (range: 20–74) and the male/female ratio was 30/12. In the first cycle of chemotherapy, four patients already received 80%-reduced CDDP due to renal dysfunction. The rate of completion without aprepitant was 90% (38/42). The worst grades of nausea were Gr.1/2/3: 14(33%)/7(16%)/1(2%). Therefore, the weekly CDDP+RT regimen does not need prophylactic APR from the first cycle of the chemotherapy, and we should use antiemetics when the patients' nausea and vomiting cannot be controlled.
