Temozolomide (TMZ) as a concomitant and
adjuvant chemotherapy to
radiotherapy following maximal surgical resection is the established standard
therapy for patients with newly diagnosed high-grade
glioma. However, detailed analysis of
chemotherapy-induced
nausea and
vomiting (CINV) associated with concomitant TMZ has not been sufficiently described. We prospectively analyzed the profile of CINV associated with concomitant TMZ. Eighteen consecutive patients with newly diagnosed high-grade
glioma treated with
concomitant chemoradiotherapy including TMZ were enrolled. CINV was recorded using a daily diary including
nausea assessment,
emetic episodes, degree of appetite suppression, and
antiemetic medication use. The observed incidence rates of all grade
nausea, moderate/severe (CTC grade 2, 3)
nausea,
emetic episodes, and appetite suppression for the overall period were 89%, 39%, 39%, and 83%, respectively. Moderate/severe
nausea and severe (CTC grade 3) appetite suppression were frequently observed during the delayed phase of the treatment.
Emetic episodes and moderate/severe
nausea were significantly correlated with female gender. Moderate/severe
nausea and severe appetite suppression were significantly correlated with low lymphocyte counts before
chemoradiotherapy. For CINV associated with concomitant TMZ, enhanced
antiemetic therapy focused on the delayed phase of the treatment will likely be beneficial, especially in female patients with a low lymphocyte count before
chemoradiotherapy.