# Prophylactic use of a combination of palonosetron hydrochloride and dexamethasone to prevent transcatheter arterial chemoembolization-induced nausea and vomiting among patients with hepatocellular carcinoma

## TL;DR

This study shows that using palonosetron and dexamethasone together helps reduce nausea and vomiting in liver cancer patients after a specific treatment.

## Contribution

The study introduces a novel prophylactic combination of palonosetron and dexamethasone to reduce TACE-induced nausea and vomiting in hepatocellular carcinoma patients.

## Key findings

- The combination of PH and DXMS significantly reduced nausea frequency compared to PH alone.
- The combination slightly reduced vomiting frequency and shortened hospital stays.
- Higher pre-TACE ALT levels were independently associated with increased nausea risk.

## Abstract

The effects of prophylactic administration of preclinical palonosetron hydrochloride (PH) and dexamethasone (DXMS) on nausea and vomiting (N/V) induced by transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) were evaluated. The goal was to furnish evidence that could guide clinical nursing practices.

A retrospective analysis was conducted on 112 patients with HCC between July and December 2022. They were categorized into two groups: those administered PH only (the PH group) and those administered a combination of PH and DXMS (the PH + DXMS group). Statistical tests including χ2, Fisher’s exact test, paired t-test, and logistic regression were employed to compare the occurrence of N/V and identify associated factors.

After TACE was administered, there was a significant increase in the occurrence of nausea (p < 0.001) and vomiting (p < 0.003) among patients in the PH group. Compared with the PH group, the frequency of nausea after TACE among patients in the PH + DXMS group was significantly reduced (67.2% vs. 37.8%, respectively; p = 0.004), and the frequency of vomiting was slightly reduced (26.9% vs. 8.9%, respectively; p = 0.060). Univariate analysis revealed that the prophylactic use of PH + DXMS prior to interventional treatment significantly reduced the days of hospitalization in patients with HCC experiencing intervention-induced nausea (p = 0.031). Logistic regression analysis revealed that the level of alanine aminotransferase (ALT) before TACE (OR = 5.833, 95% CI: 1.252–27.170, p = 0.025) was an independent factor associated with the incidence of nausea.

Prophylactic administration of a combination of PH and DXMS reduced the frequency of N/V as well as the length of hospital stay in patients with HCC. Moreover, the level of ALT before TACE was identified as a predictive factor for the incidence of nausea. Further research endeavors should explore patient-specific characteristics to optimize management strategies.