Incidence of Nausea and Vomiting in Patients With Cervical Cancer Undergoing Chemoradiotherapy With Steroid-Sparing

@article{matsumoto2026incidence,
  title = {{Incidence of Nausea and Vomiting in Patients With Cervical Cancer Undergoing Chemoradiotherapy With Steroid-Sparing}},
  author = {TAKUMA MATSUMOTO and KENSUKE YOSHIDA and MASAKI NAKAI and YUSUKE KAWAMURA and YOSHINOBU GOHARA and NAOTO HOSHINO and HAJIME MORITA and NAOYA TONOMURA and MANAMI BANBA and AYAKO YAMAGUCHI and MASAKI TACHIBANA and TOMOKI FUKUSHIMA and HIROKI HOSOKAWA and TAKUYA MURA and TSUYOSHI YABUKI and NORIAKI HIDAKA and YASUSHI SEMBA and SHINICHI WATANABE},
  journal = {In Vivo},
  year = {2026},
  month = oct,
  doi = {10.21873/invivo.14513},
  url = {https://doi.org/10.21873/invivo.14513},
  note = {CC BY-NC-ND 4.0},
}

TY  - JOUR
TI  - Incidence of Nausea and Vomiting in Patients With Cervical Cancer Undergoing Chemoradiotherapy With Steroid-Sparing
AU  - TAKUMA MATSUMOTO
AU  - KENSUKE YOSHIDA
AU  - MASAKI NAKAI
AU  - YUSUKE KAWAMURA
AU  - YOSHINOBU GOHARA
AU  - NAOTO HOSHINO
AU  - HAJIME MORITA
AU  - NAOYA TONOMURA
AU  - MANAMI BANBA
AU  - AYAKO YAMAGUCHI
AU  - MASAKI TACHIBANA
AU  - TOMOKI FUKUSHIMA
AU  - HIROKI HOSOKAWA
AU  - TAKUYA MURA
AU  - TSUYOSHI YABUKI
AU  - NORIAKI HIDAKA
AU  - YASUSHI SEMBA
AU  - SHINICHI WATANABE
PY  - 2026
DA  - 2026/10/29
JO  - In Vivo
DO  - 10.21873/invivo.14513
UR  - https://doi.org/10.21873/invivo.14513
AB  - Background/Aim: Although dexamethasone (DEX) is essential for preventing chemotherapy-induced nausea and vomiting during concurrent chemoradiotherapy (CCRT) for cervical cancer, prolonged administration carries risks of adverse events. Therefore, we evaluated the effect of a shortened DEX duration (steroid-sparing therapy) on the total control (TC) of nausea and vomiting in patients with cervical cancer undergoing CCRT comprising cisplatin 40 mg/m2 to avoid the risk of adverse effects associated with DEX administration.  Patients and Methods: This multicenter, retrospective study included 579 patients with cervical cancer who underwent CCRT between January 2016 and March 2024. Patients were classified into the steroid- sparing (DEX day 1; N=80) and non-steroid-sparing (DEX days 1-3; N=499) groups. TC was defined as the absence of vomiting and nausea without rescue medication during the entire CCRT period. A multivariate logistic regression analysis was used for between-group comparisons to adjust for potential confounders.  Results: The baseline rate of olanzapine use was significantly higher in the steroid-sparing group [28.8% vs. 10.6% (non-steroid-sparing group); p<0.001]. TC rates during the entire CCRT period were 30.0% and 36.5% in the steroid and non-steroid-sparing groups, respectively. No statistically significant difference in the overall TC period [odds ratio (OR)=0.826; 95% confidence interval (CI)=0.480-1.420; p=0.490] was observed. Furthermore, propensity score matching analysis adjusted for olanzapine use, radiation dose, and other covariates confirmed these findings (OR=0.736; 95% CI=0.370-1.460; p=0.381). However, the TC rate during the delayed phase in the non-steroid-sparing group (71.7%) was higher than that in the steroid-sparing group (60.0%), indicating an increased risk of treatment failure (OR=0.591; p=0.035). This difference was not statistically significant after Bonferroni correction (significance threshold: p<0.0125). Furthermore, propensity score-matched univariate analysis confirmed no significant difference in the delayed phase between the two groups (p=0.243).  Conclusion: Steroid-sparing therapy did not compromise TC rates, suggesting that it may be a clinically acceptable option for patients undergoing CCRT. However, individualized risk assessment and appropriate antiemetic use remain essential.
SN  - 0258-851X
SN  - 1791-7549
ER  -