Nausea, Vomiting
Conditions
Keywords
nausea, vomiting, radiation, anti-emetic drug
Brief summary
This phase II study will investigate the use of palonosetron in the efficacy of prophylaxis or rescue of single or multiple fraction radiation induced nausea and vomiting. This prospective study employs a parallel arm design, allowing for inclusion of patients with pre-existing nausea and vomiting versus no current nausea or vomiting. Eligible patients receiving radiotherapy known to have a low or moderate emetogenic risk will receive every other day dosing of 0.5 mg palonosetron for the length of treatment. Nausea, vomiting, use of rescue medication, and impact on quality of life will be monitored during and after radiation treatment completion.
Interventions
DRUGPalonosetron
Palonosetron 0.5 mg every other day until completion of radiation and at least one hour prior on days of RT
RADIATIONLow or moderate risk radiotherapy
Low or moderately emetogenic radiotherapy will be given to all patients on study.
Sponsors
Dr. Edward Chow
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Informed consent * Patient will receive radiation therapy to considered moderate risk (upper abdomen, upper and half body irradiation) or low risk (lower thorax and pelvis) emetogenic palliative radiotherapy. * Patients will be grouped according to nausea and vomiting status at baseline as follows: * Group 1: Patient is experiencing no nausea and vomiting at baseline * Group 2: Patient is experiencing at least mild nausea and/or at least mild vomiting at baseline
Exclusion criteria
* Patient is scheduled to receive cranial radiation therapy during or within 10 days following completion of protocol RT. * Patient received cranial RT within 7 days prior to commencement of protocol RT. * Patient is scheduled to receive chemotherapy during or within 10 days following completion of protocol RT. * Patient received moderately or highly emetogenic chemotherapy within 7 days prior to commencement of protocol RT. * Patient is scheduled to change regimen/dose or start the use of low dose corticosteroids (inhaled or topical permitted), or other medications considered to have antiemetic properties within 48 hours prior to protocol RT. * Patient is scheduled to change regimen/dose or start the use of low dose corticosteroids (inhaled or topical permitted), or other medications considered to have antiemetic properties during or within 10 days following completion of protocol RT. * Concurrent use of corticosteroids during protocol RT is not permitted, unless low dose corticosteroids (hydrocortisone) are used for cancer treatment * Patient is allergic to protocol medication. * Patient has a Karnofsky Performance Status score \<40. * Patient is a woman who is pregnant or of childbearing potential and is not using contraceptive measures.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy for prevention of nausea and vomiting events as measured by a daily diary | Day 0 to Day 10 post-radiation | Primary outcome is to determine the efficacy of palonosetron for the prevention of radiation-induced vomiting in patients undergoing low or moderate emetogenic radiation therapy. Daily diary collects events of nausea and/or vomiting, and corresponding severity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Complete prophylaxis of vomiting | Day 0 to Day 10 post-radiation | Proportion of patients achieving complete prophylaxis of vomiting without requiring the use of any, or supplemental rescue antiemetic medication during and in the 10 days following radiation therapy |
| Partial control of nausea | Day 0 to Day 10 post-radiation | Proportion of patients achieving partial control of nausea during and in the 10 days following radiation therapy |
| Partial control of vomiting | Day 0 to Day 10 post-radiation | Proportion of patients achieving partial control of vomiting during and in the 10 days following radiation therapy |
| Time to use of rescue medication | Day 0 to Day 10 post-radiation | Median time from first fraction of radiation therapy to first use or increase in use of rescue medication |
| Complete prophylaxis of nausea | Day 0 to Day 10 post-radiation | Proportion of patients achieving complete prophylaxis of nausea and not requiring the use of any, or supplemental rescue antiemetic medication during and in the 10 days following radiation therapy |
| Time to vomiting | Day 0 to Day 10 post-radiation | Median time from first fraction of radiation therapy to first episode or increase in episodes of vomiting |
| Quality of life | Baseline, during the 5th and 10th day of radiation (if applicable), and 3, 5, 7, and 10 days post radiation. | Quality of life as measured by the EORTC QLQ-C15-PAL and the FLIE. |
| Adverse effects | Day 0 to Day 10 post-radiation | The side effects of constipation and headache will be monitored throughout the study period graded according to the CTCAE criteria. |
| Time to nausea | Day 0 to Day 10 post-radiation | Median time from first fraction of radiation therapy to first episode or increase in episodes of nausea |
Countries
Canada
Outcome results
None listed