Central Nervous System Tumor, Pediatric, Chemotherapy-induced Nausea and Vomiting, Unspecified Childhood Solid Tumor, Protocol Specific
Conditions
Keywords
nausea and vomiting, unspecified childhood solid tumor, childhood central nervous system embryonal tumor, childhood central nervous system germ cell tumor, childhood central nervous system germinoma, childhood central nervous system mixed germ cell tumor, childhood central nervous system teratoma, childhood central nervous system yolk sac tumor, childhood mixed glioma, childhood oligodendroglioma, untreated childhood brain stem glioma, untreated childhood visual pathway and hypothalamic glioma, untreated childhood visual pathway glioma, childhood high-grade cerebellar astrocytoma, childhood high-grade cerebral astrocytoma, childhood low-grade cerebellar astrocytoma, childhood low-grade cerebral astrocytoma, untreated childhood cerebellar astrocytoma, untreated childhood cerebral astrocytoma, untreated childhood subependymal giant cell astrocytoma, childhood ependymoblastoma, untreated childhood medulloblastoma, untreated childhood pineoblastoma, childhood choroid plexus tumor, childhood craniopharyngioma, childhood supratentorial ependymoma, childhood supratentorial primitive neuroectodermal tumor, childhood medulloepithelioma, childhood infratentorial ependymoma, newly diagnosed childhood ependymoma, childhood meningioma
Brief summary
RATIONALE: Acupressure wristbands may prevent or reduce nausea and caused by chemotherapy. It is not yet known whether standard care is more effective with or without acupressure wristbands in controlling acute and delayed nausea. PURPOSE: This randomized phase III trial is studying how well acupressure wristbands work with or without standard care in controlling nausea in young patients receiving highly emetogenic chemotherapy.
Detailed description
OBJECTIVES: Primary * To compare the control of chemotherapy-induced nausea (CIN) in the acute phase provided by a 5-HT3 antagonist combined with acupressure versus placebo acupressure in children 4 to 18 years of age being treated with chemotherapy including cisplatin ≥ 50 mg/m2/dose, ifosfamide plus etoposide/doxorubicin, or cyclophosphamide plus an anthracycline. Secondary * To compare the control of CIN in the delayed phase provided by a 5-HT3 antagonist combined with acupressure versus placebo acupressure in children 4 to 18 years of age being treated with chemotherapy including cisplatin ≥ 50 mg/m2/dose, ifosfamide plus etoposide/doxorubicin, or cyclophosphamide plus an anthracycline. * To compare the control of chemotherapy-induced vomiting and retching (CIV) in the acute and delayed phases provided by a 5-HT3 antagonist combined with acupressure versus placebo acupressure in children 4 to 18 years of age being treated with chemotherapy including cisplatin ≥ 50 mg/m2/dose, ifosfamide plus etoposide/doxorubicin, or cyclophosphamide plus an anthracycline. OUTLINE: This is a multicenter study. Patients are stratified according chemotherapy regimen and anti-emetic Regimen 5-HT3 agonists (ondansetron or granisetron.) Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients wear Sea-Band acupressure wristbands on each wrist beginning approximately 30 minutes prior to the first cisplatin-containing chemotherapy course and continually for 24 hours after the last chemotherapy dose (acute phase), and for a maximum of 7 days or until the next chemotherapy course starts (delayed phase). Patients are allowed to take bands off intermittently (up to 4 times a day, for no more than 15 minutes each time) to relieve pressure or to bathe. Patients also receive standard of care anti-emetic prophylaxis comprising granisetron, ondansetron, or dexamethasone during chemotherapy according to institutional or physician preference. * Arm II: Patients wear placebo wristbands on each wrist and receive standard of care anti-emetic prophylaxis during chemotherapy as patients in arm I. Patients, parents, or guardians are instructed to complete an impatient and an outpatient diaries on nausea severity and the time of each emetic episode. Patients, parents, or guardians also complete a questionnaire about acupressure at the end of the study.
Interventions
PROCEDUREReal Acupressure Band
Acupressure wristband
PROCEDUREPlacebo Acupressure Band
Sham wristband
Sponsors
National Cancer Institute (NCI)
University of South Florida
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
4 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* 4 to 18 years of age, inclusive. The patient's cognitive ability must be considered by a parent or healthcare professional to be at least at a 4 year-old level. * Newly diagnosed (i.e., not relapsed) with any malignancy. * Patients are not required to be registered on a COG therapeutic trial. * The patient's current chemotherapy treatment plan must include at least 1 course of * cisplatin at ≥ 50 mg/m2/dose or * ifosfamide plus etoposide or doxorubicin or * cyclophosphamide plus an anthracycline. * Patients may have previously received other chemotherapy. * The patient's current treatment plan must include an anti-emetic regimen with either ondansetron or granisetron on a scheduled basis. Patients may also receive dexamethasone for antiemetic prophylaxis during the acute phase at the discretion of the treating physician. Patients ≥ 12 years old may also receive aprepitant in conjunction with dexamethasone for antiemetic prophylaxis at the discretion of the treating physician. * Patients needing anti-emetic treatment for breakthrough nausea/vomiting may also receive anti-emetic agents on an as needed (PRN) basis. * The patient (parent/guardian) must be English-speaking (i.e., able to read and speak in English) since the PeNAT has been validated only in English. * All patients and/or their parents or legal guardians must sign a written informed consent (patient assent is also recommended when applicable according to each institution's policy).
Exclusion criteria
* Prior history of acupressure use. * Scheduled use of antiemetic agents other than ondansetron, granisetron, dexamethasone or aprepitant. Patients may receive other antiemetic agents PRN for breakthrough nausea/vomiting but not on a scheduled basis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Each day of Chemotherapy course. Maximum of 7 days | CIN = Chemotherapy-Induced Nausea. The acute phase began with administration of the first chemotherapy dose of a chemotherapy block and continued until 24 hours after administration of the last chemotherapy dose of the block. Acute Phase - bands will be worn on each day of the chemotherapy course and for 24 hours after the last chemotherapy dose. Nausea severity during the acute phase of chemotherapy is defined as the maximum PeNAT (Pediatric Nausea Assessment Tool) score observed during each 24 hour period. The possible scores for the pediatric nausea assessment tool are no nausea, mild nausea, moderate nausea, severe nausea. Only patients who contributed at least 1 PeNAT score during the acute phase were included. The duration of the acute phase varied with chemotherapy regimen, according to study design. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Maximum of 7 days after Acute Phase | CIN = Chemotherapy-Induced Nausea. The delayed phase began at the end of the acute phase and continued until the first chemotherapy dose of the next chemotherapy block. Delayed Phase - Bands will continue to be worn for a maximum of 7 days or until the next chemotherapy cycle starts, whichever comes first. Nausea severity is defined as the maximum PeNAT (Pediatric Nausea Assessment Tool) score observed during each 24 hour period. The possible scores for the pediatric nausea assessment tool are no nausea, mild nausea, moderate nausea, severe nausea. Only patients who contributed at least 1 PeNAT score during the delayed phase were included. |
| Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Maximum of 14 days | CIV = Chemotherapy-Induced Vomiting. Total Duration of Study includes both acute and delayed phases. Acute Phase - bands will be worn on each day of the chemotherapy course and for 24 hours after the last chemotherapy dose. Delayed Phase - Bands will continue to be worn for a maximum of 7 days or until the next chemotherapy cycle starts, whichever comes first. A breakthrough antiemetic agent is defined as a medication that is administered or taken in order to relieve or treat (rather than prevent) nausea or vomiting. An antiemetic agent that is prescribed and/or administered on an as needed basis is considered to be a breakthrough antiemetic. Complete CIV Control during the acute and delayed phases is defined as no emetic episodes and no breakthrough anti-emetic agents administered during the phase of interest. Partial CIV Control is defined as 1 or 2 emetic episodes in any 24 ho |
Countries
Canada, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Arm I- Real Acupressure Bands Patients wear Sea-Band acupressure wristbands on each wrist beginning approximately 30 minutes prior to the first cisplatin-containing chemotherapy course and continually for 24 hours after the last chemotherapy dose (acute phase), and for a maximum of 7 days or until the next chemotherapy course starts (delayed phase). Patients are allowed to take bands off intermittently (up to 4 times a day, for no more than 15 minutes each time) to relieve pressure or to bathe. Patients also receive standard of care anti-emetic prophylaxis comprising granisetron, ondansetron, or dexamethasone during chemotherapy according to institutional or physician preference.
Real Acupressure Band: Acupressure wristband | 83 |
| Arm II- Placebo Acupressure Bands Patients wear placebo wristbands on each wrist and receive standard of care anti-emetic prophylaxis during chemotherapy as patients in arm I.
Placebo Acupressure Band: Sham wristband | 82 |
| Total | 165 |
Baseline characteristics
| Characteristic | Arm II- Placebo Acupressure Bands | Arm I- Real Acupressure Bands | Total |
|---|---|---|---|
| Age, Continuous | 12.9 Years STANDARD_DEVIATION 4.2 | 12.5 Years STANDARD_DEVIATION 4.3 | 12.7 Years STANDARD_DEVIATION 4.2 |
| Diagnosis Ewing Sarcoma | 6 Participants | 9 Participants | 15 Participants |
| Diagnosis Hodgkin Lymphoma | 29 Participants | 20 Participants | 49 Participants |
| Diagnosis Osteosarcoma | 17 Participants | 16 Participants | 33 Participants |
| Diagnosis Other | 30 Participants | 38 Participants | 68 Participants |
| Sex: Female, Male Female | 32 Participants | 37 Participants | 69 Participants |
| Sex: Female, Male Male | 50 Participants | 46 Participants | 96 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 83 | 0 / 82 |
| other Total, other adverse events | 0 / 83 | 0 / 82 |
| serious Total, serious adverse events | 0 / 83 | 0 / 82 |
Outcome results
Primary
Efficacy of Treatment on CIN During Acute Phase of Chemotherapy
CIN = Chemotherapy-Induced Nausea. The acute phase began with administration of the first chemotherapy dose of a chemotherapy block and continued until 24 hours after administration of the last chemotherapy dose of the block. Acute Phase - bands will be worn on each day of the chemotherapy course and for 24 hours after the last chemotherapy dose. Nausea severity during the acute phase of chemotherapy is defined as the maximum PeNAT (Pediatric Nausea Assessment Tool) score observed during each 24 hour period. The possible scores for the pediatric nausea assessment tool are no nausea, mild nausea, moderate nausea, severe nausea. Only patients who contributed at least 1 PeNAT score during the acute phase were included. The duration of the acute phase varied with chemotherapy regimen, according to study design.
Time frame: Each day of Chemotherapy course. Maximum of 7 days
Population: The overall number of patients analyzed is 83 for Arm I and 82 for Arm II. Patients analyzed include the total number of patients that reported at least 1 PeNAT (Pediatric Nausea Assessment Tool) score on that day. The duration of the acute phase varied with chemotherapy regimen, according to study design. The number of patients receiving chemotherapy for longer than 3 days diminished each day, so days 4-7 were collapsed and considered a single day.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 3 | No Nausea | 13 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 2 | No Nausea | 17 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 3 | Mild Nausea | 19 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 1 | No Nausea | 37 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 3 | Moderate Nausea | 18 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 2 | Mild Nausea | 23 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 3 | Severe Nausea | 20 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 1 | Moderate Nausea | 16 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Days 4-7 | No Nausea | 13 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 2 | Moderate Nausea | 24 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Days 4-7 | Mild Nausea | 10 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 1 | Mild Nausea | 17 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Days 4-7 | Moderate Nausea | 11 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 2 | Severe Nausea | 16 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Days 4-7 | Severe Nausea | 16 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 1 | Severe Nausea | 12 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Days 4-7 | Severe Nausea | 5 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 1 | No Nausea | 41 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 1 | Mild Nausea | 8 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 1 | Moderate Nausea | 19 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 2 | No Nausea | 15 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 2 | Mild Nausea | 27 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 2 | Moderate Nausea | 20 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 2 | Severe Nausea | 18 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 3 | No Nausea | 16 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 3 | Mild Nausea | 17 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 3 | Moderate Nausea | 21 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 3 | Severe Nausea | 10 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Days 4-7 | No Nausea | 16 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Days 4-7 | Mild Nausea | 12 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Days 4-7 | Moderate Nausea | 10 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Acute Phase of Chemotherapy | Day 1 | Severe Nausea | 12 Participants |
Secondary
Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy
CIV = Chemotherapy-Induced Vomiting. Total Duration of Study includes both acute and delayed phases. Acute Phase - bands will be worn on each day of the chemotherapy course and for 24 hours after the last chemotherapy dose. Delayed Phase - Bands will continue to be worn for a maximum of 7 days or until the next chemotherapy cycle starts, whichever comes first. A breakthrough antiemetic agent is defined as a medication that is administered or taken in order to relieve or treat (rather than prevent) nausea or vomiting. An antiemetic agent that is prescribed and/or administered on an as needed basis is considered to be a breakthrough antiemetic. Complete CIV Control during the acute and delayed phases is defined as no emetic episodes and no breakthrough anti-emetic agents administered during the phase of interest. Partial CIV Control is defined as 1 or 2 emetic episodes in any 24 ho
Time frame: Maximum of 14 days
Population: The overall number of participants analyzed is 83 participants in Arm I and 82 participants in Arm II. In the acute phase, 165 patients provided at least 1 PeNAT (Pediatric Nausea Assessment Tool) score. In the delayed phase, 144 patients contributed at least 1 PeNAT score.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Arm I- Real Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Acute Phase | Complete CIV Control | 17 Participants |
| Arm I- Real Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Acute Phase | Partial CIV Control | 43 Participants |
| Arm I- Real Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Acute Phase | Failed CIV Control | 23 Participants |
| Arm I- Real Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Delayed Phase | Complete CIV Control | 35 Participants |
| Arm I- Real Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Delayed Phase | Partial CIV Control | 29 Participants |
| Arm I- Real Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Delayed Phase | Failed CIV Control | 11 Participants |
| Arm II- Placebo Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Delayed Phase | Partial CIV Control | 28 Participants |
| Arm II- Placebo Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Acute Phase | Complete CIV Control | 19 Participants |
| Arm II- Placebo Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Delayed Phase | Complete CIV Control | 31 Participants |
| Arm II- Placebo Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Acute Phase | Partial CIV Control | 48 Participants |
| Arm II- Placebo Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Delayed Phase | Failed CIV Control | 10 Participants |
| Arm II- Placebo Acupressure Bands | Comparison of Control of CIV During the Acute and Delayed Phase of Chemotherapy | Acute Phase | Failed CIV Control | 15 Participants |
Secondary
Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy
CIN = Chemotherapy-Induced Nausea. The delayed phase began at the end of the acute phase and continued until the first chemotherapy dose of the next chemotherapy block. Delayed Phase - Bands will continue to be worn for a maximum of 7 days or until the next chemotherapy cycle starts, whichever comes first. Nausea severity is defined as the maximum PeNAT (Pediatric Nausea Assessment Tool) score observed during each 24 hour period. The possible scores for the pediatric nausea assessment tool are no nausea, mild nausea, moderate nausea, severe nausea. Only patients who contributed at least 1 PeNAT score during the delayed phase were included.
Time frame: Maximum of 7 days after Acute Phase
Population: The overall number of patients analyzed is 83 for Arm I and 82 for Arm II. Patients analyzed include the total number of patients that reported at least 1 PeNAT (Pediatric Nausea Assessment Tool) score on that day. The duration of the acute phase varied with chemotherapy regimen, according to study design. The number of patients receiving chemotherapy for longer than 3 days diminished each day, so days 4-7 were collapsed and considered a single day.
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 1 | No Nausea | 27 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 1 | Mild Nausea | 19 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 1 | Moderate Nausea | 19 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 1 | Severe Nausea | 10 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 2 | No Nausea | 28 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 2 | Mild Nausea | 15 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 2 | Moderate Nausea | 15 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 2 | Severe Nausea | 9 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 3 | No Nausea | 28 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Days 4-7 | No Nausea | 19 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 3 | Mild Nausea | 21 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 3 | Moderate Nausea | 12 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 3 | Severe Nausea | 4 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Days 4-7 | Mild Nausea | 13 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Days 4-7 | Moderate Nausea | 14 Participants |
| Arm I- Real Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Days 4-7 | Severe Nausea | 10 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 3 | Severe Nausea | 7 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 1 | No Nausea | 27 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 3 | No Nausea | 33 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 1 | Mild Nausea | 15 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Days 4-7 | No Nausea | 28 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 1 | Moderate Nausea | 13 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Days 4-7 | Moderate Nausea | 3 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 1 | Severe Nausea | 13 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 3 | Mild Nausea | 14 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 2 | No Nausea | 25 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Days 4-7 | Mild Nausea | 13 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 2 | Mild Nausea | 20 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 3 | Moderate Nausea | 7 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 2 | Moderate Nausea | 12 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Days 4-7 | Severe Nausea | 7 Participants |
| Arm II- Placebo Acupressure Bands | Efficacy of Treatment on CIN During Delayed Phase of Chemotherapy | Day 2 | Severe Nausea | 5 Participants |