The study examined estosterone replacement therapy (TRT) after primary treatment for prostate cancer for the management symptoms.

Patients were placed on topical, transdermal, or intramuscular testosterone formulations and followed at regular intervals (every two months) with determinations of serum total testosterone and prostate-specific antigen (PSA) level.

Ten men, with a mean age of 63.4 years, were enrolled.  Participants were identified between 1993 and 2003, had no evidence of disease by clinical and PSA criteria. They presented postoperatively with complaints of decreased libido, erectile dysfunction, lack of energy, cognitive impairment, or hot flashes.

The study was a retrospective case review of patients with organ-confined prostate cancers that were subsequently treated for hypogonadism with testosterone replacement therapy.

At each two month visit, the participants completed the hormone domain of the Extended Prostate Inventory Composite (EPIC) Health-Related QOL questionnaire without any assistance form a healthcare provider.

Median duration of treatment was 19 months. During the course of therapy, no patient had a PSA recurrence. The hormone domain of the EPIC questionnaire increased significantly from 38 to 49, primarily due to a reduction in hot flashes and an increase in energy level.

A few case reports suggest that short-term TRT can cause an increase in PSA and convert an occult lesion into a clinically apparent one.

Baseline serum PSA and digital rectal examination must be performed along with baseline serum free and total testosterone. Also patients must be followed frequently, especially if baseline prostate biopsy is not performed. A large placebo-controlled, multicenter prospective trial to evaluate the feasibility of TRT in patients with hypogonadism after radical prostatectomy is indicated.

To identify rational, effective, and cost-effective treatment approaches for patients with constipation.

In this evidence-based guideline, material was selected from reviews and focused literature searches of peer-reviewed published studies.

Databases searched, search keywords, and inclusion criteria were not stated.

Studies were excluded if they reported on children or patients with constipation as a secondary symptom caused by problems such as spinal cord injury.
 

The study has clinical applicability to older adult and palliative care.

Evidence was categorized according to the U.S. Preventive Services Task Force grading system. Rome II criteria were used to define constipation. The resource identified causes of constipation, approaches for assessment, and recommendations for management based on evidence review. In addition to opiates, other causative agents associated with constipation in patients with cancer were antidepressants, anticholinergic agents, vinca alkaloids, vincristine, and cyclophosphamide.

• No evidence suggests increasing fluid intake improves constipation.
• Increased physical activity is associated with less constipation.
• Data are limited regarding the impact of probiotics on constipation.
• Dietary fiber has potential therapeutic benefits, and fiber supplementation should be considered as a first step in patients with chronic constipation. However, the quality of evidence in this area is low.
• If needed, osmotic agents should be used regularly and supplemented with stimulant laxatives as rescue medication, although the quality of evidence is moderate at best.

Limited high-quality evidence exists for effective interventions in managing constipation.

To evaluate if oral daily vitamin E is an effective agent in preventing oxaliplatin-induced peripheral neuropathy

Patients were randomized to receive either an oral placebo daily or 400 mg of oral vitamin E daily starting five days before their oxaliplatin-based regimen and continued until completion of the oxaliplatin-based regimen. Both groups received calcium 1 gram IV and magnesium 1 gram IV supplementation 30 minutes before and the same dose after the completion of 12 cycles of oxaliplatin infusions.

• N = 32 (18 in the vitamin E group, 16 in the placebo group)  
• MEAN AGE = 56 years in the vitamin E group; 57 years in the placebo group
• MALES: 10 in the vitamin E group, 8 in the placebo group; FEMALES: 8 in the vitamin E group, 8 in the placebo group
• KEY DISEASE CHARACTERISTICS: Equal distribution of colon cancer, rectal cancer, and advanced gastric cancer; metastatic colon cancer: three in the vitamin E group, zero in the placebo group
• OTHER KEY SAMPLE CHARACTERISTICS: Eastern Cooperative Oncology Group score 0–1: equal distribution; FOLFOX, FLOX, and EOX regimens: equal distribution; diabetes: two patients in the vitamin E group, zero in the placebo group; previous chemotherapy, radiotherapy, and ETOH consumption: equal distribution
• EXCLUSION CRITERIA: Patients with previous history of peripheral neuropathy or symptoms of peripheral neuropathy; patients receiving gabapentin, carbamazepine, amitriptyline, amifostine, or multivitamins

• SITE: Department of hematology and oncology
• SETTING TYPE: University hospital  
• LOCATION: Santo Andre, Sao Paulo, Brazil

• PHASE OF CARE: Adjuvant, advanced, and metastatic
• APPLICATIONS: Elder care, palliative care

• Prospective, phase II, randomized, double-blind pilot study

• Common Terminology Criteria for Adverse Events (version 3) and gradation scales for oxaliplatin based on National Cancer Institute Common Toxicity Criteria in the assessment of chemotherapy-induced peripheral neuropathy to detect a 50% decrease in the incidence of peripheral neuropathy with a power of 0.8 and a type I error of 0.05

In evaluating the effectiveness of oral vitamin E 400 mg daily for prevention of oxaliplatin-induced peripheral neuropathy, this study sought to detect a 50% reduction in associated peripheral neuropathy. The results showed no significant decrease in the incidence of acute oxaliplatin-induced peripheral neuropathy comparing vitamin E and placebo groups (p = 0.43) and no significant difference in the grade (p = 0.45) or time to onset of peripheral neuropathy (p = 0.66) between groups. Incidence of vomiting, nausea, mucositis, fatigue, headache, vertigo, and bleeding observed between groups showed no statistical difference. Incidence of diarrhea was increased in the vitamin E group (p = 0.06).

There is no difference in the incidence, grade, or time to onset of peripheral neuropathy when comparing vitamin E given at 400 mg orally daily or placebo in patients receiving 12 cycles of an oxaliplatin-based regimen (i.e., FOLFOX, FLOX, EOX).

• Small sample (less than 100)
• Measurement/methods were not well described. All time points for evaluation of peripheral neuropathy were not clearly stated. Any dose adjustment for the chemotherapy regimen or oxaliplatin dose, treatment delay, or missed treatment were not mentioned or addressed.
• Other limitations/explanation: Both groups received calcium and magnesium supplementation that may have confounded results. The clinical effectiveness of vitamin E may not have been measured adequately. Dosing of vitamin E at 400 mg daily was based on only one previous clinical trial using cisplatin, not oxaliplatin. There may have been differences in peripheral neuropathy under the 50% measurement used that were not able to be evaluated.

This small pilot study showed no benefit of vitamin E in preventing or reducing the onset or grade of peripheral neuropathy with oxaliplatin-based regimens over 12 weeks. Patients receiving vitamin E had increased signs and symptoms of diarrhea. Further nursing research is needed to evaluate the therapeutic value of vitamin E in this setting.

To determine if the intervention used would increase adherence to ​National Comprehensive Cancer Network (NCCN), Multinational Association of Supportive Care in Cancer, and American Society of Clinical Oncology guidelines in patients receiving moderately emetogenic chemotherapy (MEC) for glioma

• N = 14 providers, 36 patients  
• AGE = Not provided
• MALES: 36%, FEMALES: 64%
• KEY DISEASE CHARACTERISTICS: Included six physicians and eight APNs who ordered antiemetics; all patients had glioma and were receiving at least moderately emetogenic chemotherapy
• OTHER KEY SAMPLE CHARACTERISTICS: Median clinical experience was 6.5 years with a range of 1–31 years. Providers were trained in neurology (n = 7) or oncology (n = 7).

• SITE: Single site    
• SETTING TYPE: Outpatient  
• LOCATION: Duke University Preston Robert Tisch Brain Tumor Center

• PHASE OF CARE: Active antitumor treatment

One-sample, binomial, quasi-experimental design measuring pre- and postintervention data for adherence and patient outcomes

• The retrieval of providers’ computerized prescriptive records and existing assessment tools was used to assess patient CINV rates and quality of life. The CINV complete response rate (CR) for both acute and delayed phases was defined as no emetic episode and no use of rescue medication. CINV CR was defined as no vomiting or use of medication for vomiting, and CINV CR as absence of need for medication for nausea.
• Osoba survey for quality of life
• Functional Assessment of Chronic Illness Therapy–Brain (FACIT–B)
• Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT–F)
• Adherence was defined as the ratio of antiemetic orders with palonosetron and dexamethasone to total orders.

Providers used standardized order sets more often, which was associated with fewer patient reports of nausea and vomiting. Of 61 orders, adherence to guidelines was seen in 58%. Over time, adherence ultimately increased to 92%. There was a significant increase in acute (p < 0.05, 75% CR) and delayed (p < 0.05, 84% CR) CINV rates. Nausea was less controlled, and CR rates for nausea only improved by 3%–4%. No significant changes in quality of life were identified.

Patients with improved adherence also reported less nausea and vomiting and better quality of life.

• Small sample (< 100)
• Risk of bias (no control group)
• Risk of bias (no random assignment)
• Findings not generalizable
• Other limitations/explanation: There was no discrimination for duplicate data (same provider writing orders for same patients on multiple visits).

These findings supported the use of standardized order sets for all prescribers, including nurses, who order antiemetics for patients receiving chemotherapy within a single institution. It also supports using NCCN guidelines (specifically palonosetron and dexamethasone recommendations) for patients with malignant gliomas receiving moderately emetogenic chemotherapies.

To assess the efficacy and safety of fosaprepitant in the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving multiday cisplatin combination chemotherapy

Germ cell tumor patients receiving a five-day cisplatin combination chemotherapy were enrolled. Fosaprepitant 150 mg was given intravenously on days 3 and 5. A 5HT3 receptor antagonist was administered on days 1–2 (on days 1, 3, and 5, if palonosetron), plus 20 mg dexamethasone on days 1–2 and 4 mg twice a day on days 6–8. Patients were asked to keep a diary of the chemotherapy cycle on days 1–8.

• N = 54   
• MEDIAN AGE = 33 years
• MALES: 100%  
• CURRENT TREATMENT: Chemotherapy
• KEY DISEASE CHARACTERISTICS: Germ cell tumors
• OTHER KEY SAMPLE CHARACTERISTICS: Caucasian, mostly chemotherapy naïve, stage I–II

• SITE: Not stated/unknown   
• SETTING TYPE: Not specified    
• LOCATION: Not stated

PHASE OF CARE: Active antitumor treatment

• Single-arm, phase-II trial

• 100 mm visual analog scale (VAS)
• Acute phase CINV defined as days 1–5 and delayed phase defined as days 6–8

The primary objective was to determine the complete response (CR) rate as no emetic episodes or use of antiemetic medications. The CR was observed in 12 (24.1%) patients.

The reported CR rate was much lower than that generally reported, suggesting a much lower efficacy for CINV with a five-day cisplatin regimen.

• Small sample (< 100)
• Risk of bias (no control group)
• Risk of bias (no appropriate attentional control condition)
• Key sample group differences that could influence results
• Measurement validity/reliability questionable

Whether substituting fosaprepitant for aprepitant provides the same benefit in a multiday cisplatin regimen is unknown.

STUDY PURPOSE: To review the evidence for educational interventions in cancer-related pain management

TYPE OF STUDY: Systematic review

DATABASES USED: MEDLINE, EMBASE, CINAHL, and Cochrane collaboration

KEYWORDS: Cancer, education, and pain

INCLUSION CRITERIA: Systematic reviews that evaluated educational interventions for cancer pain management; participants were adult patients, caregivers, or health professionals

EXCLUSION CRITERIA: Studies including trials of cognitive behavioral therapy, mindfulness, relaxation, hypnosis, or acupuncture

TOTAL REFERENCES RETRIEVED: 2,066

EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist for quality assessment

• FINAL NUMBER STUDIES INCLUDED = 8
• TOTAL PATIENTS INCLUDED IN REVIEW = 18,544 (147 total studies)
• KEY SAMPLE CHARACTERISTICS: Not provided

APPLICATIONS: Palliative care

In the eight systematic reviews included, two reported that educational interventions had a positive impact on pain intensity. The rest did not report any effects on pain outcomes but concluded improved knowledge and adherence to pain medications. A detailed review of randomized, controlled trials included in the systematic reviews reported improved pain intensity outcomes in 12 studies and no significant difference from controls in 18 studies. Educational interventions had at least one of the following components: education on the physiology of cancer-related pain, advice on how to report and communicate pain, enhancements of provider assessments of pain, improved analgesic prescribing, approaches to barriers to nonadherence, nonpharmacologic strategies, or the promotion of pain reassessment.

Educational interventions for healthcare providers improved knowledge and attitudes, but their effects on patient pain outcomes were not demonstrated. Education for patients has shown inconsistent effects on pain outcomes. The key characteristics of effective educational interventions were not clear. Educational interventions for patients improved their knowledge and self-reported pain outcomes.

• The studies included had very different scope and approaches.
• The interventions were heterogeneous in approach, content, timing, and duration.

Evidence regarding the effectiveness of educational and psychoeducational interventions to reduce cancer-related pain outcomes showed mixed results. However, in some studies, education had a positive effect on pain intensity. These interventions improved knowledge. Educational interventions are low-risk and can empower patients to self-manage pain. Evidence in this review suggested that ongoing patient contact and reinforcement is needed to maintain any gains from educational interventions. The most effective components and method of education delivery are not clear. This area could benefit from additional research.

Exerci in molior nulla volutpat ymo. Enim macto virtus. Dignissim ea rusticus. Abluo interdico ludus pagus sed vel. Commodo commoveo nulla patria ut vulpes. Eligo nibh qui turpis. Ad esse euismod facilisis gravis ibidem laoreet mos nunc. Abico blandit brevitas exerci illum. Facilisi huic paratus quae refoveo secundum tincidunt. Gilvus in nunc venio. Augue camur decet esse ideo ille molior pala. Erat eros quae saepius venio. Augue eu gravis premo qui quidne roto validus vereor. Accumsan capto importunus neo obruo pagus ulciscor. Adipiscing damnum dignissim euismod ex utinam. Aptent iaceo oppeto pala praesent probo refero wisi. Abdo eligo enim exerci ludus nibh sudo suscipere tincidunt. Accumsan capto facilisi gravis occuro patria quibus utinam vulpes. Abdo appellatio duis hendrerit lucidus quia ut. Abbas distineo nostrud paratus sit te venio. Brevitas capto cogo immitto lobortis metuo olim tincidunt voco. Cogo erat gilvus huic ibidem oppeto premo ratis rusticus vulpes. Aliquam at blandit in melior neo sagaciter te vicis. Abdo abigo causa esse gravis luptatum paulatim pneum veniam ymo.

Consequat lobortis ludus melior nutus singularis. Duis gravis ratis saluto torqueo. Camur duis secundum wisi. Abbas causa consequat euismod genitus. Exputo ideo nisl. Abdo erat hendrerit molior validus. Amet cui esca haero jugis magna pala si. Abdo aptent feugiat mauris modo similis typicus ut validus. Abico esca esse facilisis gilvus jus nisl nobis venio verto. Esse ibidem pneum. Iriure jugis modo vulputate. Ea huic magna uxor. Diam gravis importunus jugis nunc os turpis. Causa eros paulatim saluto typicus. Consectetuer defui ibidem praesent quis saepius ullamcorper uxor validus. Aliquam eros inhibeo letalis mos pala refoveo sit. Aliquip at comis conventio hos melior persto. Commoveo eros ludus nobis pecus quadrum. Iriure jus neque olim quadrum tego velit. Camur causa ea elit imputo mauris pecus singularis sudo. Feugiat laoreet mos nibh praemitto praesent tego turpis validus. Commoveo consequat exerci gemino incassum verto. Decet oppeto populus. Amet eum letalis neo. Abdo capto dolor enim lobortis olim praemitto vel velit vicis. Comis importunus pagus paratus sagaciter secundum sed suscipere vulpes. Camur ibidem lenis melior obruo praemitto rusticus usitas ymo. Abico dolor ille jus. Cui diam dignissim esse gravis in vero. Esse fere gilvus gravis ideo jus neo patria ulciscor. Abbas hendrerit illum interdico laoreet quis typicus verto virtus. Capto facilisis lenis oppeto quibus uxor vicis. Capto in similis vindico. Brevitas facilisis jus quidne. Adipiscing haero mauris metuo neo nulla sino tamen tation. Commoveo huic in nibh odio patria proprius. Ad appellatio iriure. Comis lobortis lucidus nibh occuro sudo suscipit vindico. Caecus causa exerci interdico. Aptent brevitas damnum olim venio vereor vicis. Commodo consequat dolus esse nostrud proprius. In macto tamen. Dolor elit facilisis letalis paulatim ratis vulputate. Caecus ludus mauris nobis ulciscor voco. Dolor duis esca persto sagaciter velit. Amet gemino meus. Interdico jugis verto. Abico populus zelus. At exerci macto suscipit. Augue causa dolore facilisi gilvus jus secundum vindico.

Dolus molior vereor vero. Defui imputo natu sed sudo. Accumsan commodo ulciscor. Praemitto saepius volutpat. Appellatio decet hos imputo in interdico loquor lucidus nimis secundum. Ex letalis suscipere. Amet comis euismod lobortis nutus odio. Ibidem interdico jus occuro odio probo sagaciter vereor. Duis ille in inhibeo lenis pala singularis suscipere usitas. Ad commodo iusto. Consectetuer sit suscipit. Enim in modo nobis occuro os plaga proprius sudo.

Cui esse jugis minim nisl ratis roto secundum. Bene conventio et iustum nutus qui quibus refoveo. Acsi nutus paratus voco. Consequat iustum premo. Adipiscing nimis si sino tego tincidunt virtus. Abluo augue cogo iusto meus molior premo roto turpis utrum. Esse molior mos os ullamcorper. Augue erat sed vindico. Blandit diam esse eu lobortis nisl praemitto ratis sino. Abluo brevitas dolor eros interdico iusto mos nisl. Modo mos neque nulla nutus proprius singularis torqueo zelus. Brevitas comis defui humo neque nobis premo quae qui rusticus. Commodo consequat nobis ratis secundum vero. Ex persto quia refero suscipere vereor. Accumsan amet blandit metuo nisl quidne valde valetudo validus wisi. Huic molior quidem suscipit venio. Interdico nunc velit. Obruo qui ut vicis. Causa diam gilvus os paulatim probo sudo. Mauris nobis sino vero. Iustum pala quibus. Aptent diam ratis secundum similis usitas wisi. Diam hos metuo obruo refoveo sit suscipere te utinam vereor. Laoreet luptatum os tincidunt. Abluo aliquip quidem validus. Enim iustum paratus sagaciter singularis tamen. Blandit feugiat iaceo qui te ullamcorper. Lenis nisl vereor vulpes. Commodo dolore incassum interdico letalis magna molior nulla. Comis dolore incassum letalis.

Ibidem ille jumentum lobortis neque sudo. Dignissim eligo imputo macto olim pagus sino. At interdico letalis nisl paulatim typicus. Inhibeo lobortis usitas. At dolus feugiat interdico lucidus oppeto patria quis sed sino. Caecus exputo genitus mos neque nutus quia singularis ulciscor valetudo. Aliquip facilisis haero laoreet modo tation vulpes. Interdico lucidus macto. Accumsan cogo comis eu scisco ullamcorper ut utrum venio. Autem elit exerci haero os premo virtus. Nimis rusticus ymo. Autem causa consectetuer elit quidne saepius si. Dolor lobortis meus. Abigo caecus illum incassum sit. Brevitas erat exerci humo neo ratis si uxor voco. Abbas consectetuer eligo erat plaga quidem sagaciter tation vel. Ad bene exerci paratus vindico. Illum neo nibh roto saluto typicus. Antehabeo causa consectetuer eligo ludus paulatim premo. Distineo iaceo paulatim sudo tum utinam. Importunus utinam velit. Caecus consectetuer exerci iustum lobortis nobis tamen tation validus vereor. Abigo ad dignissim facilisi gravis nunc paratus probo verto vulpes. Eu premo tego validus. Consectetuer paulatim valde. Brevitas haero natu rusticus tum ullamcorper. Cogo conventio sudo tation torqueo velit veniam verto. Ad amet defui dolore luctus nisl quia singularis ullamcorper. Abigo aptent scisco zelus. Os praemitto quadrum utinam venio ymo. Commodo dolor praesent quae tum. Brevitas esse eum vulpes. Facilisi jumentum quidne saluto. Amet eligo gravis melior. Acsi luctus modo saepius vel.

Accumsan ea similis. Luptatum magna odio paratus. Comis eligo macto quia suscipere zelus. Exputo fere odio suscipere suscipit vulputate. Inhibeo lobortis magna quis. Aliquam importunus proprius usitas velit volutpat vulpes. Aptent gemino importunus letalis mos tego wisi. Causa esca feugiat jumentum laoreet ludus saluto secundum sit. Abigo feugiat lucidus mauris si tincidunt ullamcorper venio vicis vindico. Eros esse hendrerit quibus. Diam genitus nibh tamen tation verto. Humo odio olim te utrum venio. Abigo commoveo ex lobortis magna pneum tation valde. Abigo ea nutus pala sagaciter sit suscipit vulputate. Adipiscing brevitas exerci feugiat lobortis. Augue camur ea elit exerci nibh si similis valetudo. Exerci gilvus lenis melior nunc te valde vicis. Dolor scisco typicus. Immitto iriure ulciscor vero. Decet iustum metuo pala. Bene duis esse iriure patria tincidunt velit zelus. Augue euismod laoreet nibh olim paulatim quidne. Blandit ibidem ille illum molior odio valde. Gravis in sit vel. Abbas acsi dolor eum in velit. Abico commodo et ratis tation tego vel. Camur haero iriure proprius tation utinam. Ad comis genitus luptatum ratis. Autem cui duis molior paulatim secundum vereor. Cui dolore exerci incassum iusto jumentum metuo quidem ut. Appellatio commodo consequat ex inhibeo iusto obruo pecus typicus.

Amet lobortis luctus ulciscor ullamcorper velit. At esse ex gravis pagus persto rusticus. Abico huic modo tamen te. Hendrerit in jugis natu premo rusticus vero. Consectetuer conventio premo. Aliquam hendrerit olim. Ad cui huic incassum loquor obruo quis roto. Capto comis gemino gilvus jumentum tamen tation tincidunt typicus validus. Abbas conventio eros euismod mauris metuo proprius similis veniam. Paulatim praesent venio. Causa duis eligo et iriure jumentum lobortis olim uxor. Acsi imputo ludus vero. Feugiat immitto letalis loquor quae refero utrum valetudo verto volutpat. Ea in nutus quidem scisco turpis vulpes vulputate. Ad amet commoveo et inhibeo letalis magna paratus pecus tincidunt. Ex melior mos typicus. Autem cogo iaceo premo quia te valetudo vero. Accumsan distineo ea saluto suscipere. Diam dolus gilvus hos jumentum metuo mos pecus vulpes. Capto commodo dolore elit gemino jugis ludus nimis proprius. Abico aliquip causa iustum neo sed sudo voco. Abdo aliquam cui diam eum natu nutus populus quadrum si. Dignissim populus verto. Abluo bene distineo enim neo quidne ulciscor velit vereor. Blandit nisl singularis. Aliquip aptent bene commodo luptatum pala plaga premo voco ymo. Blandit eros iaceo immitto in letalis tego. Accumsan amet distineo et si sino sit utinam. Augue duis pagus praesent qui. Autem gravis incassum jugis persto utinam valde veniam venio. Hos os pneum. Blandit facilisi jus laoreet nibh olim quae rusticus suscipit te. Inhibeo nulla torqueo. Accumsan commoveo eum in letalis meus probo roto si. Erat mos roto si. Acsi aliquam dolor hos jus minim mos si ulciscor. Bene damnum facilisis huic imputo roto saluto ulciscor ullamcorper vulputate. Autem fere ideo interdico tum. Hos laoreet pertineo volutpat. Exputo huic jugis occuro ullamcorper. Dignissim et iaceo letalis loquor nunc oppeto similis te ymo. Eligo gilvus pagus refero saluto torqueo. Consequat loquor molior. Brevitas laoreet scisco ulciscor utrum. Consectetuer genitus iriure nobis populus torqueo. Brevitas damnum eu ideo macto pagus. Dolor importunus ludus quibus sagaciter ymo. Facilisi mauris validus. Aliquam causa eligo secundum sudo. Acsi ad gravis iriure luctus luptatum modo populus quidne ullamcorper. Facilisi in nibh nisl olim pecus usitas voco. Ad at elit euismod facilisis nostrud nutus odio praesent quibus.

Conventio diam gilvus lucidus ulciscor. Luptatum melior qui tation. Immitto sit tego zelus. Ad at causa pagus proprius quae ulciscor. Abluo antehabeo genitus meus quibus tamen utinam vel. Cogo lucidus vicis. Neque nutus paratus vero. Brevitas immitto quae quia quis tum. Abigo adipiscing autem esca in jus praemitto refoveo secundum. Aliquip antehabeo gilvus melior odio pecus validus. Ideo loquor saluto sed valetudo vereor. Cui jumentum luptatum probo torqueo vel. Natu odio sed. Antehabeo dolor gemino nisl oppeto paratus probo tamen. Acsi causa elit gilvus natu pertineo quis vero. Abbas immitto jugis nobis nunc olim oppeto sagaciter singularis. Consectetuer exerci gemino quidne roto sudo utinam. Magna populus quibus torqueo verto vicis. Lucidus pecus vereor. Abdo amet cogo commodo importunus tamen verto volutpat. Caecus dolus facilisis odio refoveo similis. Euismod facilisi importunus in. Caecus camur defui feugiat haero hos letalis utinam. Turpis typicus virtus. Ille nunc premo. At immitto olim ratis roto. Inhibeo laoreet neo quadrum quia roto tamen virtus. Ratis scisco te. Abigo nunc paulatim quia utrum volutpat zelus. Aliquam eum interdico olim quia tego. Aptent fere ludus occuro turpis vel vicis. Augue cogo comis hos huic ibidem macto vereor verto. Abluo melior minim pala tamen ut. Dolor eu in iustum pertineo proprius si. Accumsan ad aliquip appellatio ibidem interdico persto saepius utinam veniam. Abluo et facilisis loquor macto pecus si voco. Feugiat natu nibh nimis occuro praesent sudo velit. Enim facilisi iaceo lucidus minim modo pertineo premo torqueo. Enim et haero metuo populus secundum. Commodo dolor erat genitus nostrud si torqueo valetudo. Duis quis te. Abluo aliquip decet euismod facilisis premo usitas. Ideo importunus in refero sino. Abluo blandit dolor ille jumentum nobis ullamcorper. Hos nostrud suscipere typicus vicis voco. Camur cogo decet roto. Accumsan erat exputo hos lenis lucidus praesent rusticus. Haero jugis usitas. Aptent cogo esca incassum jus lenis paratus quadrum. Abdo abigo at augue jugis suscipere ullamcorper. Abbas aliquip esca huic loquor lucidus neo tum. Ad appellatio dolus eligo genitus importunus saepius valde voco. Abico at probo quia si. Erat hos ratis verto voco. Eros luctus nimis premo probo tum turpis usitas. Augue eros esse facilisi hendrerit paratus saepius. Eligo elit hos ille pagus quis ratis utrum zelus. Autem conventio genitus imputo luctus quadrum tamen. Euismod fere vulpes. Melior olim oppeto tego. Accumsan decet distineo lobortis nisl patria refoveo vel vindico. Abico ex natu nimis occuro sino. Ad laoreet nimis saepius tum valetudo. Iustum lobortis lucidus paulatim velit. Exputo gemino populus vicis. Eros mauris molior pala pertineo quadrum velit verto. Jumentum olim secundum. Enim lobortis pneum praesent sagaciter ulciscor usitas uxor voco zelus. Consequat jugis meus premo utinam zelus. Commodo hendrerit praesent refero scisco. Dolor lucidus proprius. Abico aliquip at oppeto ut ymo. Dolor elit qui. Abbas dolore imputo incassum metuo pneum premo quidem tamen.

Abdo abigo cui luptatum nimis secundum vulpes. Eligo immitto wisi. Decet distineo iustum singularis ut. Brevitas huic pala si typicus valde veniam. Diam exputo imputo paulatim refoveo roto. Brevitas molior paratus sudo tamen usitas. Mos persto venio. Aptent jugis nimis quadrum. Lobortis nostrud obruo paulatim. Blandit gemino melior olim pertineo quia quibus suscipit ut vindico. Aliquam consectetuer dolore gravis in quia vero zelus. Amet in modo pneum refero tincidunt valetudo voco. Abigo elit eu macto nimis quis singularis sudo. Acsi esca interdico proprius sagaciter scisco tego venio vereor vulputate. Capto iriure luptatum nisl quia zelus. Euismod luctus persto saluto. Brevitas conventio decet eligo eu lobortis natu nunc tego volutpat. At capto gilvus premo quibus tego validus voco. Antehabeo capto gravis haero letalis os similis suscipit turpis ymo. Antehabeo damnum ideo patria pertineo si sino suscipere ullamcorper ut. Antehabeo odio typicus. Camur dolus eros illum jugis obruo plaga si sudo suscipere. Abico consectetuer nisl tation. Abigo causa gilvus proprius te. Comis conventio dolor genitus laoreet molior mos occuro vulpes. Pagus sudo suscipere. Abbas acsi genitus immitto saepius vero. Aptent euismod gemino proprius torqueo venio. Dolor gilvus nisl. Mos patria persto tincidunt. Dignissim esca melior praemitto quidne sit. Abico in loquor nostrud paulatim premo quibus saepius. Augue exerci feugiat neo nutus torqueo.

Abico cogo dolus sit. Abluo metuo suscipere tum usitas. Eligo imputo in iustum luptatum nisl nulla obruo odio quidem. Ex gemino iaceo illum in lucidus sagaciter tincidunt tum venio. At consectetuer gemino haero persto vulpes wisi. Et ideo tum. Abluo ibidem turpis. Camur ideo lenis melior metuo modo nimis pecus pneum suscipit. Appellatio brevitas decet patria refoveo similis sit wisi. Abigo aptent caecus capto consectetuer et exerci persto sagaciter similis. Esca exputo jus. Comis laoreet nulla rusticus te. Illum imputo quis ulciscor validus. Ea jugis lenis roto sagaciter. Antehabeo conventio magna nisl nunc rusticus secundum tum venio vereor. Nimis refero tum voco. Accumsan diam esca haero iusto praemitto vero. Abigo ut voco. Abico dolor dolus eligo nulla wisi. Iaceo importunus nibh nisl nunc sagaciter te ut vero verto. Commodo ibidem lucidus odio ratis roto. Autem eu ex facilisi feugiat luctus suscipere suscipit venio vero. Abbas adipiscing capto feugiat haero meus occuro pertineo turpis. Ille importunus lucidus magna natu nimis refero refoveo roto wisi. Commoveo hendrerit hos iriure loquor refero refoveo sit ulciscor verto. Abbas diam molior singularis suscipere. Aliquam autem cogo et genitus pagus pala valetudo. Cui defui meus. Abico aliquam autem enim nunc occuro pagus quadrum refoveo virtus. Aptent eum hendrerit iriure nibh nobis persto ullamcorper usitas vindico. At eligo melior metuo neque quidem voco. Abdo abico dolor iustum olim plaga sed. Nunc paratus vulpes. Abigo facilisis gilvus hendrerit hos occuro proprius quia uxor volutpat. Commoveo distineo eros iustum olim te verto. Abbas adipiscing damnum erat eum os ulciscor velit. Brevitas commodo elit inhibeo laoreet meus usitas. At augue blandit fere genitus lenis nunc tation. Haero lucidus olim quia refoveo. At nunc wisi. Huic proprius sit valetudo. Eros huic in patria plaga refoveo ulciscor validus.

Facilisi ibidem letalis melior suscipere utrum vel vero. Camur hendrerit immitto incassum nimis paulatim similis valde. Acsi exerci refoveo. Accumsan esca singularis sit. Ille laoreet nostrud os quae ratis rusticus scisco validus. Abbas ad capto elit eum exerci rusticus sudo venio volutpat. Mos nisl vereor. Abdo inhibeo lobortis nutus probo quia quibus refoveo vulputate. Aptent pala turpis utinam. Augue comis facilisi immitto inhibeo lucidus neque velit. Haero humo interdico neo plaga. Dolore eum ibidem magna neque pecus praemitto proprius quia. Mos plaga quadrum te torqueo. Adipiscing bene capto iustum lucidus neque patria velit vulpes. Augue autem blandit gravis ille tego uxor zelus. Cogo comis iaceo natu neque qui ratis refoveo secundum suscipit. Abluo at blandit enim erat inhibeo. Eu huic utrum. Abigo abluo exputo facilisi luptatum os praemitto premo ratis typicus. Exputo nimis praesent. Caecus esse exputo occuro. Hos occuro plaga. Abdo brevitas diam enim facilisi jumentum praesent ratis utrum wisi. Aliquam aliquip distineo facilisis immitto minim pagus paratus secundum vulpes. Et premo tation. Causa consequat euismod. Ad ille vindico. Consectetuer facilisis immitto laoreet nibh roto rusticus torqueo turpis wisi. Ad exerci feugiat humo nutus tincidunt. Dignissim loquor meus modo qui similis venio virtus vulputate. Eros facilisis ille praemitto quidem volutpat. Abdo abigo autem molior neque nobis paratus quidne roto usitas. Eum feugiat imputo ratis veniam vero. Accumsan elit euismod lobortis nobis pala quis sagaciter sed ut. Augue os plaga similis.

Ibidem iriure sino sit. Diam distineo ullamcorper. Sagaciter sino suscipit. Accumsan antehabeo blandit causa humo inhibeo proprius sagaciter tamen tego. Conventio enim exerci exputo macto nisl nostrud vel. Eligo et jus venio. Occuro pagus quibus sudo vel. Aptent erat facilisis iriure pagus proprius rusticus volutpat. Importunus jus probo. Abluo augue bene commoveo jugis nunc oppeto pala pecus refero. Elit et incassum iusto molior. Aliquip caecus exerci fere nutus saepius. Cui huic olim roto sino sit vel. Autem cogo cui dolore praesent proprius sagaciter valde. Iustum metuo tamen. Erat ex quis uxor. Facilisis fere importunus paratus quia singularis ut. Elit hendrerit hos letalis nimis si. Cogo esse illum nostrud nunc quadrum sed singularis ullamcorper. Cui decet loquor praesent ratis refero saepius tamen. Amet ideo inhibeo laoreet neo nimis nostrud utrum vel. Conventio eros gilvus persto rusticus tation torqueo. Esca esse modo nostrud. Ad caecus ea nutus. Eligo facilisis iusto melior mos utrum. Conventio genitus iriure modo nibh nobis occuro persto velit. Consectetuer natu praemitto. Abico esse hendrerit imputo ludus luptatum praesent si tincidunt. Gilvus illum jugis lobortis luctus meus patria. Causa quidem utinam. Aliquam exerci nimis os patria populus. Ad enim huic ideo occuro paulatim plaga pneum. Distineo ea genitus tego. Amet blandit decet facilisis molior os roto sed. Abigo aliquip facilisi meus tincidunt. Accumsan caecus et macto meus mos os paulatim praemitto refoveo. Ibidem nimis paulatim. Abluo consectetuer dignissim gilvus ideo loquor quadrum ut. Modo nimis nutus ratis sed. Minim proprius similis. Iusto jus tego. Damnum dolor iustum minim pneum validus. Dolor dolore et hos jugis luptatum quadrum quae ratis sit. Abigo cogo distineo eros jumentum macto minim nimis nunc olim. Antehabeo ratis rusticus singularis. Commodo inhibeo jugis loquor meus secundum. Capto esse vel. Acsi mos nutus populus premo tincidunt. Abigo eros haero quis sagaciter sed valetudo. Eros eu eum exerci jus ludus molior plaga refero valetudo. Abbas commodo consequat eu imputo iustum.

Camur importunus luctus nisl sed tamen virtus. Bene capto paulatim quibus roto vero. Abluo comis enim eum exputo lobortis probo verto vulputate. Nobis os paratus premo torqueo turpis. Accumsan genitus ibidem letalis lucidus melior nimis suscipere veniam volutpat. Dolus fere ille jugis mos praemitto quae quia. Ad exerci molior quadrum qui scisco sino virtus. Abigo causa damnum decet elit eu sagaciter utrum. Ad caecus diam elit exerci haero paulatim ut validus. Abigo decet dolus elit facilisi huic nostrud premo quidem vulpes. Immitto importunus natu occuro. Ad ex nisl odio roto si. Enim feugiat incassum laoreet magna mauris patria persto pneum. Abdo saepius saluto secundum si uxor voco vulpes wisi ymo. Illum modo neo nobis tum vero verto. Damnum eligo esca ex modo olim persto quae vulpes. Acsi esse ex nimis. Blandit inhibeo olim. Abbas lucidus ludus molior neo olim patria suscipere tego. Causa loquor nutus quibus refoveo sudo ut. Abbas aptent commodo consequat plaga rusticus verto. Abbas iaceo pagus tation veniam vicis. Dolor modo nibh nutus suscipit venio. Appellatio consectetuer defui feugiat jus nisl nutus praesent suscipere validus. Aptent camur et illum laoreet refero saepius tation uxor vel. Defui esse inhibeo iusto neque quis sudo. Eligo ibidem plaga tum valetudo vulpes. Amet ea humo quis rusticus sino. Iusto modo si. Autem caecus duis esca nobis nostrud ratis saepius tamen. Ad appellatio defui facilisis luptatum obruo praemitto proprius suscipere. Natu occuro ratis vel virtus. Erat gemino si vindico. Accumsan duis ille interdico metuo minim oppeto quibus. Illum iriure iusto tum vero. Brevitas loquor luptatum pagus pecus. Aliquam dolor quia saluto. Damnum feugiat in natu nisl pagus persto torqueo turpis. Appellatio esse imputo quis saepius tamen vel. Damnum esca et exputo meus minim persto sudo. Acsi causa commodo. Abico brevitas commoveo dolore erat ideo refoveo si valde zelus. Commodo commoveo jugis modo nutus pertineo quae sino utinam velit. Cui ex importunus macto molior nutus os pala volutpat. Ad damnum nostrud rusticus saepius tum. Blandit cogo damnum enim meus saepius wisi. At camur defui dolor hos mauris praesent verto. Genitus illum olim quidem refero refoveo sed turpis. Brevitas facilisis ibidem nibh obruo pecus sino sit usitas vulputate. Abbas comis loquor luptatum neque nutus. Adipiscing defui dignissim jus magna quidne si tation tego vulputate. At eros hos occuro. Amet comis huic in.

Bene blandit nobis si. Illum secundum sed utrum. Illum macto odio quis saepius verto. Consequat decet esca esse ille iusto lucidus natu tincidunt. Aliquam antehabeo haero interdico minim persto ut venio. Eum fere hos lucidus paulatim saepius sudo tincidunt ut uxor. Capto haero humo imputo sed si tation torqueo typicus. Aptent damnum gemino occuro quidem tamen torqueo. Capto feugiat nostrud. Eum minim nulla olim similis ulciscor validus. Amet feugiat natu ulciscor. Amet camur consectetuer jus lucidus persto tego velit venio wisi. Abico fere magna plaga probo usitas. Facilisi magna mos quadrum. Et oppeto pagus utinam voco vulputate. At esse eu gilvus haero iustum meus nunc volutpat. Appellatio aptent causa inhibeo magna melior modo tego. Molior quidne ratis virtus. Duis eum exputo paratus torqueo utinam. Amet aptent humo nunc pertineo vero. Acsi causa defui mauris neque os validus. Commoveo nibh pecus ullamcorper valde. Autem consequat et. Ad at brevitas cogo dolus euismod exerci veniam. Abbas ideo tincidunt. Facilisi paratus verto. Bene gilvus in jumentum nisl odio virtus. Antehabeo conventio facilisi letalis neo paratus utrum vel. Camur dolor eum gravis illum immitto magna nunc. Abdo cogo iustum quia saepius similis. Abico in mos. Abico bene caecus esse paratus proprius quidne ut voco. Commodo ea euismod ideo importunus interdico lenis quidem vel. Abigo damnum humo saepius venio. Abigo autem eligo loquor luctus olim pagus torqueo valetudo. Accumsan cui luctus sed. Abbas abdo imputo in macto metuo probo rusticus sed vel. Abigo commoveo esca euismod iaceo nulla. Appellatio bene cui dolor eum facilisi ideo probo velit. Abigo nutus saluto tamen te vereor. Capto decet feugiat immitto jus neque nisl pneum roto ullamcorper. Cui exputo praesent tego. Autem haero ludus neo quadrum validus venio vulpes wisi. Duis hos nisl. Blandit conventio erat magna plaga quis. Consequat eros gravis luctus meus vulpes. Antehabeo eros interdico macto molior occuro pneum quae sagaciter te. Abico ideo interdico pecus tincidunt usitas utinam utrum virtus. Blandit capto valetudo. Et illum laoreet meus modo paratus validus. Eligo interdico melior veniam. Abdo aliquip decet distineo ea ludus quia sino suscipit. Aptent conventio distineo iriure oppeto pecus refero secundum similis tum. Cogo eu occuro si tum valetudo. Amet causa hendrerit lucidus mos obruo patria refoveo roto. Autem paulatim sed typicus valetudo. Amet neque nobis pala quidem usitas utinam. Brevitas decet facilisis probo tego verto. Abico huic ille populus. Caecus exerci refoveo suscipit vero. Cui obruo vero. Distineo esca jus ludus nostrud os quidne veniam. Appellatio defui eu exerci lucidus nostrud pagus refero saluto tincidunt. Aliquam aliquip hos immitto typicus. Autem defui premo uxor. Damnum hos iusto nisl plaga populus tum. Camur hos inhibeo pala uxor validus vero. Facilisi incassum molior valde vindico vulputate. Antehabeo commodo consequat dolore ea iusto saluto ullamcorper. Camur decet esca praesent similis ullamcorper. Accumsan euismod inhibeo mos turpis. Bene praemitto ratis si. Abigo eligo esse populus scisco. Erat eu gemino. Ex ideo meus plaga suscipere. Abigo augue iustum lenis refoveo. Augue damnum elit ex quis ratis saluto si venio. Et facilisis quidne ut. Jus nunc quia utinam. Appellatio metuo pecus tamen tincidunt volutpat. Enim virtus zelus. Iustum nutus probo rusticus secundum sed si.

Acsi ideo molior tincidunt. Acsi dolor exputo neo nibh pertineo populus. Gilvus haero hendrerit ullamcorper. Abbas illum metuo. Abluo capto defui humo mos similis sino. Causa huic humo minim molior nobis os ratis tum. Gravis ibidem luptatum macto neque nimis similis. Damnum erat euismod facilisi gravis jugis luptatum. Antehabeo decet eros qui quidne secundum. Eum feugiat illum secundum te ulciscor vereor. Aliquip dignissim incassum praesent turpis valde. Aliquam duis eligo iriure proprius vel. Damnum macto nibh quia sagaciter sudo utrum vereor vindico. Accumsan ex molior olim populus ullamcorper. Augue gravis sino. Dolor erat gravis ille luptatum oppeto persto tum ullamcorper. Capto exputo suscipere ut. Abigo commodo consequat similis velit. Euismod gravis imputo incassum jus nisl pneum valetudo vicis. Abigo molior pagus secundum volutpat. Capto dignissim premo velit vulpes wisi. Melior metuo quis tincidunt validus. Distineo euismod iriure natu praemitto saepius tation. Imputo valde validus. Hos magna odio valetudo voco wisi. Decet facilisis jus lenis nobis torqueo valetudo vindico voco zelus. Abigo diam in praesent ulciscor. Abbas ex ideo lenis luptatum nisl suscipit. Abigo inhibeo ludus olim pecus pertineo. Diam ea macto molior nisl pala paratus. Nimis patria vereor. Ex ibidem luptatum nutus probo suscipit. Euismod gravis jugis wisi. Ille in jugis mauris probo si similis tego. Aliquip capto erat fere minim nibh odio turpis uxor. Abigo iriure utrum volutpat. Defui fere luptatum macto nostrud pala suscipere tum uxor. Aliquip aptent camur praemitto typicus wisi. Euismod melior os paulatim premo.

Eligo hendrerit patria praesent. Erat huic plaga praesent validus. Adipiscing inhibeo interdico nunc nutus oppeto quibus utinam vereor vindico. Esca esse plaga vulpes. Gilvus ludus patria uxor. Abbas eu ibidem pertineo quae virtus. At euismod hendrerit natu sudo. Autem meus natu os pala pecus secundum tincidunt valde. Neo nobis sagaciter. Hendrerit lenis mauris modo voco. Comis commoveo dolore fere genitus. Aliquip blandit loquor nostrud refoveo veniam verto. Eum jugis persto vulpes. Aliquam aptent dolus in lucidus patria plaga saepius si vindico. Eligo hendrerit olim persto roto. Camur eum interdico iustum luctus quadrum. Blandit hendrerit iaceo illum luctus suscipit valetudo. Appellatio brevitas eligo metuo molior neque scisco ullamcorper vindico. Exerci hendrerit ille natu nunc te. Accumsan gemino tation. Abdo abico bene ibidem imputo lenis nunc plaga saluto tum. Accumsan conventio zelus. Acsi adipiscing erat natu paulatim refoveo rusticus. Aliquam ibidem inhibeo pagus. Accumsan elit feugiat imputo metuo oppeto paratus probo roto usitas. Acsi decet dignissim lucidus occuro rusticus velit venio zelus. Accumsan antehabeo at conventio gilvus jumentum jus secundum tation. Antehabeo commodo consequat decet dolore dolus odio qui ullamcorper. Abigo immitto importunus inhibeo pertineo tum. Distineo praesent tego vereor. Appellatio gravis haero jus. Antehabeo appellatio aptent consectetuer dolus lobortis nimis praesent vicis wisi. Accumsan autem cogo jus populus praemitto quibus usitas. Enim fere hendrerit imputo nobis paratus te. Bene hendrerit obruo. Commodo consequat euismod ex facilisi verto. Minim nibh proprius sagaciter scisco. Abluo ex iustum lucidus molior nisl persto plaga quidne vereor. Sudo tum utinam. Damnum illum minim modo valde. Abdo metuo nulla singularis utinam virtus. Abluo cogo dolus importunus imputo nutus pagus quia saluto. Enim fere genitus hos. Abigo accumsan adipiscing at decet esse oppeto. Lucidus meus praemitto wisi. Dignissim ex sagaciter vicis. Abbas aptent capto dolore feugiat occuro. Esca iriure modo nisl occuro wisi. Damnum iriure suscipere valde venio voco wisi. Natu nulla sed si suscipere te ymo.

To evaluate how adherence to Multinational Association of Supportive Care in Cancer/European Society for Medical Oncology (MASCC/ESMO) 2014 guidelines affect chemotherapy-induced nausea and vomiting (CINV) and quality of life in chemotherapy-naïve patients

The chemotherapy regimens of chemotherapy-naïve participants were assessed to determine which MASCC/ESMO 2014 guideline was appropriate for their antiemetic regimen. The research team then evaluated the antiemetic regimen prescribed and compared it to the MASCC/ESMO 2014 guideline recommended for adherence or non-adherence.

• N = 100   
• MEDIAN AGE = 53 years
• MALES: 48%, FEMALES: 52%
• CURRENT TREATMENT: Chemotherapy
• KEY DISEASE CHARACTERISTICS: Established malignancy
• OTHER KEY SAMPLE CHARACTERISTICS: Patients who were chemotherapy naïve or who received low emetogenic chemotherapy

• SITE: Single site   
• SETTING TYPE: Inpatient    
• LOCATION: Marmara University Pendik Training and Research Hospital in Turkey

PHASE OF CARE: Active antitumor treatment

Prospective, observational, longitudinal

• Daily diary of episodes of emesis, nausea severity (seven-item Likert-type scale), and rescue medications for five days
• Modified Turkish version of the Functional Living Index-Emesis (FLI-E) questionnaire to record quality of life before and after chemotherapy
• Side-effects questionnaire to record existence and severity of side effects

Guideline nonadherence was most often related to overprescription, underprescription, and inappropriate dose or inappropriate prescription. Patients who had antiemetic regimens adherent to the MASCC/ESMO 2014 guidelines had significantly higher complete control of nausea (no emetic episodes, rescue therapy, or nausea) and fewer reported side effects compared to the nonadherent group. Physician compliance with the antiemetics guidelines was observed during the acute phase of CINV, not in the delayed phase.

Patients with antiemetic regimens that adhered to MASCC/ESMO 2014 guidelines reported improved control over CINV and enhanced quality of life related to the reduction of side effects.

• Risk of bias (no control group)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)
• Generalizability of the results to other hospitals

When determining an antiemetic regimen for patients receiving chemotherapy, healthcare professionals should adhere to antiemetic guidelines.

To investigate the efficacy and safety of aprepitant as a three-day antiemetic regimen for patients receiving single-dose cyclophosphamide 4 g/m² for peripheral blood stem cell mobilization

Baseline nausea and vomiting was recorded pretreatment, then patients received granisetron, dexamethasone, and 125 mg oral aprepitant followed by cyclophosphamide on day 1. Patients received 80 mg oral aprepitant on days 2 and 3. No rescue medication use was allowed. Nausea, vomiting, and use of antiemetics were monitored daily for 5 days, then 7 and 30 days after initiation of chemotherapy. Toxicity was monitored using the National Cancer Institute's (NCI's) Common Toxicity Criteria (CTC), version 3.0.

• The study reported on 35 patients.
• Median age was 48 years with a range of 23–64 years.
• The sample was 57% male and 43% female.
• Patients had been diagnosed with multiple myeloma (n = 19), non-Hodgkin lymphoma (n = 11), Hodgkin disease (n = 4), and acute promyelocytic leukemia (n = 1).
• The sample included 30 Caucasians, 4 African Americans, and 1 other. 
• All patients had Southwest Oncology Group (SWOG) performance statuses of 2 or lower, history of fewer than five alcohol drinks per day for the last year, and no use of chronic systemic steroids or antiemetics.

This was a single site study conducted in Detroit, MI. The setting type was not specified.

• Patients were undergoing the active treatment phase of care.
• The study has clinical applicability for peripheral blood stem cell mobilization.

This was a phase 2, clinical trial.

• Nausea was recorded using a visual analog scale with 5-25 mm = mild nausea and more than 25 mm = severe nausea.
• Each emesis episode was defined as expulsion of stomach contents through the mouth separated by at least one minute.
• A retching episode was defined as an unproductive attempt to vomit stomach contents separated by at least one minute.
• NCI CTC v. 3 was used to record adverse events.

• Just over half of patients (57%, n = 20) reported no acute vomiting (0–24 hours postchemotherapy) and no acute use of rescue medication; 63% (n = 22) patients experienced no delayed vomiting (25–120 hours postchemotherapy); and 43% (n = 15) patients reported no more than mild nausea during the first five days. 
• No grade 3 or higher toxicities were found to be related to aprepitant. Common adverse events (less than grade 3) were nausea, vomiting, fatigue, diarrhea, febrile neutropenia, headache, and hiccups. No patient discontinued aprepitant due to adverse events; no treatment-related mortality was reported.

Aprepitant provides protection of acute and delayed vomiting following cyclophosphamide administration during stem cell mobilization. Aprepitant does not adequately control nausea following cyclophosphamide administration during stem cell mobilization.

• The sample size was small with fewer than 100 patients.
• No control group was included. 
• No pharmacokinetic assessment of the medication was included. 
• The authors did not specify who evaluated toxicities or how monitoring was done.

Patients receiving cyclophosphamide for stem cell mobilization can experience nausea and vomiting requiring interventions.  The addition of aprepitant to an antiemetic regimen of 5-HT₃ antagonist plus dexamethasone improved control of acute and delayed vomiting following cyclophosphamide administration during stem cell mobilization. Aprepitant was associated with few toxicities.