Metin DEMİRKAYA, Betül SEVİNİR, Ramazan ÖZDEMİR, Meliha DEMİRAL

Kanserli çocuklarda kemoterapi ile ilişkili gecikmiş bulantı ve kusma

Giriş: Çocuk onkoloji hastalarında kemoterapi ile ilişkili gecikmiş bulantı ve kusmanın insidansı ve ilişkili faktörler araştırıldı. Gereç ve Yöntem: Çalışmaya Ocak-Aralık 2009 tarihleri arasında, 0-18 yaş arası, lenfoma ve solid tümörlü, kemoterapi alan hastalar dâhil edildi. Hastaların kusmaları sayı olarak, bulantı şiddetleri ise 0-10 arası rakamsal ölçme yöntemi ile derecelendirildi. Bulantı şiddeti ve kusma sayıları günlük olarak aynı hekim tarafından kaydedildi. Bulgular: Çalışmada 35 hastada, 69 kemoterapi kürü sonrası gecikmiş bulantı ve kusma atağı incelendi. Hastaların 22’si kız, 13’ü erkek; yaş ortalaması 8,88±5,43 yıl (yaş aralığı 1-17 yıl) idi. Hastalarda gecikmiş bulantı varlığı 1. gün %2,8, 2. gün %81,1, 3. gün %68,1, 4. gün %46,3, 5. gün %24,6; gecikmiş kusma varlığı ise 1. gün %1,4, 2. gün %65,2, 3. gün %43,5, 4. gün %24,6, 5. gün %13,0 oranında idi. Cinsiyetler arasında gecikmiş bulantı şiddeti ve kusma sayısı açısından fark saptanmadı. Yaş ile gecikmiş bulantı şiddeti arasında 2, 3, 4 ve 5. günlerde istatistiksel olarak anlamlı pozitif korelasyon mevcuttu (korelasyon katsayısı sırasıyla; 0,29, 0,27, 0,33, 0,24; p değeri sırasıyla; =0,013, =0,023, =0,005, =0,046). İlaçların emetojenite derecesinin kusma sayısı ve bulantı şiddetine istatistiksel olarak anlamlı etkisi saptanmadı. Sisplatinli kemoterapi protokolü alanlarda kusma sayısı ikinci ve üçüncü günlerde; bulantı şiddeti birinci, ikinci ve üçüncü günlerde istatistiksel olarak anlamlı olacak şekilde fazla idi. Sonuç: Çalışmamızda bulantı ve kusmanın en yüksek oranda ikinci gün var olduğu, sisplatin alan hasta grubunda kusma sayısı ve bulantı şiddetinin daha fazla olduğu ve yaşla bulantı şiddetinin pozitif korelasyon gösterdiği saptandı. (Güncel Pediatri 2011; 9: 1-6)

Delayed chemotherapy-induced nausea and vomiting in children with cancer

Introduction: The incidence of chemotherapy-induced late emesis and vomiting in pediatric oncology patients and the related factors were investigated. Materials and Method: The study consisted of the patients aged between 0-18 years and given chemotherapy between January and December 2009. The amount of vomiting was described on numbers and the grade of nausea was described between 0-10. Vomiting and nausea was evaluated daily by the same clinician. Results: Sixty nine late nausea and vomiting episodes in 35 patients were evaluated. There were 22 females and 13 males in the study group. Mean age was 8.88±5.43 (1 to 17) years. Late nausea was found 2.8% on the first day, 81.1% on the second day, 68% on the third day, 46.3% on the fourth day and 24.6% on the fifth day. Late emesis was found 1.4% on the first day, 65.2% on the second day, 43.5% on the third day, 24.6% on the fourth day and 13% on the fifth day. There was no significant difference in nausea and emesis between boys and girls. There was a positive correlation between the age and nausea/emesis episodes. The correlation coefficients between age and nausea grade on 2, 3, 4 and 5th days were 0.29, 0.27, 0.33, and 0.24, respectively; and p values were 0.013, 0.023, 0.005 and 0.046, respectively. The degree of the emetogenic potential of drugs on the number of emesis and the severity of nausea was found to be not significant. The vomiting was statistically significant on second and third days and grade of nausea on first, second and third days in the patients given cisplatin. Conclusion: In this study, it was found that emesis was most seen in the second day of chemotherapy, the grade of vomiting was higher in patients receiving cisplatin and there is a positive correlation between age and grade of nausea. (Journal of Current Pediatrics 2011; 9: 1-6)

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