Thực trạng sử dụng thuốc dự phòng nôn, buồn nôn và các phản ứng truyền dịch trên bệnh nhân ung thư vú đang hóa trị tại Khoa Nội vú - phổi, Bệnh viện Ung bướu Hà Nội

Abstract

Objective: To investigate the characteristics and effectiveness of antiemetic prophylaxis and infusion-related reaction (IR) prevention in breast cancer patients undergoing chemotherapy at the Department of Breast and Lung Medical Oncology, Hanoi Oncology Hospital. Subject and method: A prospective descriptive study conducted from December 16, 2024, to January 16, 2025, involving all patients meeting the inclusion and exclusion criteria. Chemotherapy-induced nausea and vomiting (CINV) were assessed through interviews, while IRs were observed during drug administration. Results: Among the 223 patients included in the study, the most commonly used chemotherapy regimens at the time of assessment were paclitaxel monotherapy (28.25%), AC (anthracycline and cyclophosphamide) (19.73%), and TC (taxane and cyclophosphamide) (12.11%). The majority of patients (83.86%) received chemotherapy via intravenous infusion. The proportion of patients at high risk of emesis was 23.77%, moderate risk was 12.56%, and the remainder were at low or very low risk. Regarding preventable IR risk, 68 regimens included paclitaxel and 52 regimens included docetaxel. Most patients received a combination of 5-HT3 antagonists and dexamethasone for acute CINV prophylaxis, regardless of emesis risk. Only 25% of patients at moderate risk and 32.08% at high risk received prophylaxis for delayed CINV. All patients receiving intravenous chemotherapy were given IR prophylaxis. The most common regimen was dexamethasone combined with diphenhydramine, used in 78,61% of patients. The overall rate of patients without CINV during the study was 68.16%; however, in the high-risk group, this rate was only 30.2%. There were 8 patients who experienced grade 1 or 2 of IR. Conclusions: The combination of 5-HT3 antagonists and dexamethasone was insufficiently effective for preventing CINV in high-risk patients. Current guidelines on antiemetic and IR prophylaxis should be reviewed to minimize the risks of IRs and toxicity.