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Exploration of treatment strategies and susceptibility gene of postoperative nausea and vomiting in breast cancer patients: a randomised controlled trial

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Abstract

Background

A history of severe nausea and vomiting during pregnancy (SNVP) is a risk factor for postoperative nausea and vomiting (PONV). This study aimed to explore potentially effective treatment strategies and potential genetic factors underlying SNVP risk-related PONV.

Methods

A total of 140 female patients undergoing breast cancer surgery were assigned to either the study group (70 with SNVP) or the control group (70 with mild to moderate nausea and vomiting during pregnancy (MNVP)). Patients in each group were randomly assigned to two different treatment subgroups and received either ondansetron plus dexamethasone (OD) or OD + TEAS (ODT) (transcutaneous electrical acupoint stimulation, TEAS). Blood samples were collected from patients before induction (D0) and 24 h (D1) after surgery for growth differentiation factor 15 (GDF-15) evaluation. The primary outcome was the incidence of PONV within 36 h. The secondary outcome was the serum GDF-15 level.

Results

The incidence of PONV in the SNVP group was significantly higher than that in the MNVP group within 24 h (P < 0.005). In the SNVP group, ODT-treated patients had less PONV than those in the OD-treated group during the 6–12 h (P = 0.033) and 12–24 h (P = 0.008) intervals, while within 6 h, there were fewer vomiting cases in the ODT-treated group (SNVP-ODT vs. SNVP-OD, 7/33 vs. 19/35, P = 0.005). The preoperative GDF-15 serum levels in patients with SNVP were significantly higher (P = 0.004). Moreover, higher preoperative GDF-15 serum levels correlated with a higher incidence of PONV (P = 0.043).

Conclusions

TEAS showed significant effect on PONV treatment in patients with SNVP. A higher serum GDF-15 level was associated with a history of SNVP, as well as a higher risk of PONV.

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Availability of data and materials

All the data used and analyzed are available from the corresponding author upon reasonable request.

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Acknowledgements

We thank our colleagues at the Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Bei**g, 100021, China.

Funding

This study was funded by Bei**g Hope Run Special Fund of Cancer Foundation of China (LC2021L05), the Special Research Fund for Central Universities, Peking Union Medical College (3332021033) and Bei**g Hope Run Special Fund of Cancer Foundation of China (LC2022A17). The funders had no role in study design, data collection and analysis, preparation of the manuscript, or decision to publish.

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Author notes

  1. Baona Wang and Huaqing Chu contributed equally to this work.

Authors and Affiliations

  1. Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Bei**g, China

    Baona Wang, Huaqing Chu, Shi**g Wei, Jiao Geng, Mengyuan Xu, **n Zhang, Jie Yu & Hui Zheng

  2. Department of Outcomes Research, Outcomes Research Consortium, Cleveland Clinic, Cleveland, OH, USA

    Baona Wang & Huan Hsu

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  1. Baona Wang
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Contributions

WBN, CHQ and ZH contributed to study design, data collection and analysis, drafting of manuscript. WSJ, HH, GJ, XMY, YJ and ZX contributed to data collection and interpretation, and revised the manuscript.

Corresponding author

Correspondence to Hui Zheng.

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This article does not contain any studies with animals. performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Wang, B., Chu, H., Wei, S. et al. Exploration of treatment strategies and susceptibility gene of postoperative nausea and vomiting in breast cancer patients: a randomised controlled trial. Breast Cancer (2024). https://doi.org/10.1007/s12282-024-01606-1

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