The Burden of Chemotherapy Induced Nausea and Vomiting on Patients’ Daily Lives: Italian Perspectives

  • E. Ballatori
  • F. Roila
  • B. Ruggeri
  • A. A. Bruno
  • S. Tiberti
  • F. di Orio
Reference work entry


The Italian Group for Antiemetic Research evaluated the appropriateness of antiemetic prophylaxis of chemotherapy-induced nausea and vomiting (CINV) in two large observational studies carried out in Italy in 1996 (antiemetic guidelines not yet published) and 1999 (MASCC guidelines published in 1998). The pattern of prescription had improved, but less than expected, given the published guidelines. A further study performed on cisplatin treated patients showed that almost all patients received the recommended prophylaxis of acute emesis, but only about half of them were treated according to the current guidelines.

The impact of CINV on patients’ daily lives was investigated using the Functional Living Index or Emesis / FLIE) questionnaire. Both acute and  delayed CINV were responsible for the impact of CINV on patients’ daily lives, but their interaction was not significant: their impact on patients’ daily lives is a simple sum of effects. About 50% of patients who experienced either acute or delayed CINV had an impact on their daily life. This percentage increased to up to 90% in patients who suffered from both acute and delayed CINV.

At a unifactorial analysis both intensity and  duration of CINV were found significant in determining the impact of CINV on patients’ daily lives, but at a multifactorial analysis adjusting for the effect of each variable on the other, only duration remained significant. This finding suggests that the duration of CINV should be assessed with an accuracy much greater than that currently used.

Despite the improved antiemetic prophylaxis, CINV is still prevalent and often impacts the patients’ daily lives, especially in the delayed phase. A further effort should be made to reduce the incidence of CINV not only by strengthening antiemetic research, but also by utilizing the best antiemetic treatments in daily clinical practice.


Daily Clinical Practice Emetogenic Chemotherapy Antiemetic Prophylaxis Acute Emesis Acute Nausea 
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List of Abbreviations:


American Society of Clinical Oncology


chemotherapy induced nausea and vomiting


European Organization for Research and Treatment of Cancer


European Society of Medical Oncology


Functional Living Index for Emesis


health-related quality of life


Italian Group for Antiemetic Research


 Linear Predictor


Multinational Association of Supportive Care in Cancer


Neuro-kinine 1


no (or minimal) impact on daily life; 30 items r.a., receptor antagonists


EORTC Quality of Life Questionnaire-Core 30 items


receptor antagonists



Tables 50-4 , 50-6 , 50-7 and 50-9 were reproduced with kind permission of Springer Science and Business Media.

We thank Mrs. Katherine Brandt for her helpful assistance in reviewing the text.


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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • E. Ballatori
  • F. Roila
  • B. Ruggeri
  • A. A. Bruno
  • S. Tiberti
  • F. di Orio

There are no affiliations available

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