Tohoku J. Exp. Med., 2021 June, 254(2)

Nomogram for Predicting Chemotherapy-Induced Nausea and Vomiting for Breast Cancer Patients

Xin-Juan Huang,¹ Xu-Ying Li,¹ Jin-Hua Li,¹ Zhe-Yu Hu,² Lu Luo,³ Yan Tan,¹ Hong-Yun Chen,⁴ Rong-Rong Fan,⁵ Tong-Yu Wang,⁶ Ling-Qi Meng⁵ and Tao Wei¹

¹Department of Nursing, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
²Department of Breast Cancer, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
³Department of Mammary Glands, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China
⁴Department of Nursing, University of South China, Hengyang, Hunan, China
⁵Xiangya School of Nursing, Central South University, Changsha, Hunan, China
⁶School of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, China

Chemotherapy-induced nausea and vomiting (CINV) is a common side effect of cancer treatment. The factors influencing CINV in breast cancer patients remain unclear. In this study, we developed a nomogram for predicting the occurrence of CINV in this group using prospective clinical data. We pooled data from multiple studies which focused on the emetogenic chemotherapy. Then, we collected 334 breast cancer patients at Hunan Cancer Hospital (training set) to analyze the demographic and clinical variables. Using multivariate logistic regression, we identified the five significant factors that were associated with CINV: history of CINV, chemotherapy regimen, chemotherapy cycle, metastasis, and symptoms of distress. Then, we construct a prediction nomogram. The external validation set comprised an additional 66 patients. The reliability of the nomogram was assessed by bootstrap resampling. The C-index was 0.78 (95% confidence interval [CI], 0.73-0.85) for the training set and 0.74 (95% CI, 0.62-0.85) for the validation set. Calibration curves showed good concordance between predicted and actual occurrence of CINV. In conclusions, our nomogram model can reliably predict the occurrence of CINV in breast cancer patients based on five significant variables, which might be useful in clinical decision-making.

Keywords —— breast cancer; chemotherapy-induced nausea and vomiting (CINV); nomogram; predictive model; risk factors

© 2021 Tohoku University Medical Press

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Tohoku J. Exp. Med 2021, 254, 111-121.

Correspondence: Xu-Ying Li, M.D., Ph.D., Department of Nursing, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, 283# Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China.

e-mail: lixuying@hnca.org.cn