TY - JOUR
T1 - International radiation oncology trainee decision making in the management of radiotherapy-induced nausea and vomiting
AU - Dennis, Kristopher
AU - Zhang, Liying
AU - Lutz, Stephen
AU - van der Linden, Yvette
AU - van Baardwijk, Angela
AU - Holt, Tanya
AU - Lagrange, Jean-Leon
AU - Foro-Arnalot, Palmira
AU - Wong, Lea-Choung
AU - Maranzano, Ernesto
AU - Wong, Kam-Hung
AU - Liu, Rico
AU - Vassiliou, Vassilios
AU - Corn, Benjamin W.
AU - De Angelis, Carlo
AU - Holden, Lori
AU - Wong, C. Shun
AU - Chow, Edward
PY - 2013/7
Y1 - 2013/7
N2 - This study explored international radiation oncology trainee decision making in the management of radiotherapy-induced nausea and vomiting (RINV). Radiation oncology trainees who were members of the national radiation oncology associations of the USA, Canada, Netherlands, Australia, New Zealand, France, Spain and Singapore completed a Web-based survey. Respondents estimated the risks of nausea and vomiting associated with six standardised radiotherapy-only clinical case vignettes modelled after international anti-emetic guidelines and then committed to prophylactic, rescue or no therapy as an initial management approach for each case. One hundred and seventy-six trainees from 11 countries responded. Only 28 % were aware of any anti-emetic guideline. In general, risk estimates and management approaches for the high-risk and minimal risk cases varied less and were more in line with guideline standards than were estimates and approaches for the moderate- and low-risk cases. Prophylactic therapy was the most common approach for the high-risk and a moderate-risk case (83 and 71 % of respondents respectively), while rescue therapy was the most common approach for a second moderate-risk case (69 %), two low-risk cases (69 and 76 %) and a minimal risk case (68 %). A serotonin receptor antagonist was the most commonly recommended prophylactic agent. On multivariate analysis, a higher estimated risk of nausea predicted for recommending prophylactic therapy, and a lower estimated risk of nausea predicted for recommending rescue therapy. Radiation oncology trainee risk estimates and recommended management approaches for RINV clinical case vignettes varied and matched guideline standards more often for high-risk and minimal risk cases than for moderate- and low-risk cases. Risk estimates of nausea specifically were strong predictors of management decisions.
AB - This study explored international radiation oncology trainee decision making in the management of radiotherapy-induced nausea and vomiting (RINV). Radiation oncology trainees who were members of the national radiation oncology associations of the USA, Canada, Netherlands, Australia, New Zealand, France, Spain and Singapore completed a Web-based survey. Respondents estimated the risks of nausea and vomiting associated with six standardised radiotherapy-only clinical case vignettes modelled after international anti-emetic guidelines and then committed to prophylactic, rescue or no therapy as an initial management approach for each case. One hundred and seventy-six trainees from 11 countries responded. Only 28 % were aware of any anti-emetic guideline. In general, risk estimates and management approaches for the high-risk and minimal risk cases varied less and were more in line with guideline standards than were estimates and approaches for the moderate- and low-risk cases. Prophylactic therapy was the most common approach for the high-risk and a moderate-risk case (83 and 71 % of respondents respectively), while rescue therapy was the most common approach for a second moderate-risk case (69 %), two low-risk cases (69 and 76 %) and a minimal risk case (68 %). A serotonin receptor antagonist was the most commonly recommended prophylactic agent. On multivariate analysis, a higher estimated risk of nausea predicted for recommending prophylactic therapy, and a lower estimated risk of nausea predicted for recommending rescue therapy. Radiation oncology trainee risk estimates and recommended management approaches for RINV clinical case vignettes varied and matched guideline standards more often for high-risk and minimal risk cases than for moderate- and low-risk cases. Risk estimates of nausea specifically were strong predictors of management decisions.
KW - Anti-emetic
KW - Emesis
KW - Nausea
KW - Radiotherapy
KW - Trainee
KW - Vomiting
U2 - 10.1007/s00520-013-1759-x
DO - 10.1007/s00520-013-1759-x
M3 - Article
C2 - 23440546
SN - 0941-4355
VL - 21
SP - 2041
EP - 2048
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 7
ER -