A Review of the Current Situation of Nausea and Vomiting in Children with Malignant Tumors After Chemotherapy and the Scope of Its Influencing Factors

Abstract

Context and Objective: Chemotherapy-induced nausea and vomiting (CINV) is one of the most common adverse reactions in children with malignant tumors. Severe CINV not only compromises comfort and treatment adherence but also increases the risk of malnutrition. This scoping review aimed to map the incidence and influencing factors of CINV in this population and provide guidance for future nursing research and intervention development. Methods: Following Arksey and O’Malley’s framework, we comprehensively searched 7 databases, including PubMed, Web of Science, Cochrane Library, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang, and Sinomed, from inception to April 11, 2025. Studies reporting the incidence or influencing factors of CINV in children aged 1 - 18 years with malignant tumors were included. Two reviewers independently screened the studies, extracted data, including study characteristics, incidence rates, and influencing factors, and performed a narrative synthesis. The quality of the included studies was appraised using the Agency for Healthcare Research and Quality (AHRQ) tool for cross-sectional studies and the Newcastle-Ottawa Scale (NOS) for cohort and retrospective studies. Study Selection: Risk factors reported in all studies on chemotherapy-related nausea and vomiting in children with tumors were reviewed and classified. Two researchers conducted the initial screening, evaluation, and selection of the included studies. Two researchers extracted the study data, and 1 researcher reviewed and verified the extracted data. The extracted data were synthesized and analyzed using a narrative approach. Results: Of 7783 identified records, 14 studies, including a total of 3099 participants, met the inclusion criteria. Publication years ranged from 2015 to 2025. The incidence of CINV varied widely, from 30% to 92%, depending on the study population and CINV type. A total of 18 influencing factors were identified and categorized into 4 domains: Individual differences, such as older age and low Body Mass Index (BMI); therapeutic factors, such as highly emetogenic chemotherapy and longer chemotherapy block time; psychological factors, such as anxiety and previous history of nausea or vomiting; and other factors, such as smoking environment and comorbid conditions. The methodological quality of the included studies was generally moderate to high. Conclusions: Chemotherapy-induced nausea and vomiting remains a prevalent issue in pediatric oncology and is associated with a complex interplay of patient-related, treatment-related, and psychological factors. Future research should focus on developing and testing personalized, multimodal interventions targeting modifiable risk factors, with particular attention to populations underrepresented in the current literature. This review highlights the need for standardized assessment and reporting of CINV to facilitate evidence-based care.