Chemotherapy-Related Nausea and Vomiting: Etiology and Management

Morrow, Gary R.

doi:10.3322/canjclin.39.2.89

Cited by 51 publications

(31 citation statements)

References 24 publications

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“…There are certain factors that affect the risk of CINV, including sex, alcohol intake, age, history of motion sickness, pregnancy sickness or previous CINV, and factors related to the chemotherapeutic treatment [5][6][7][8]. Of these factors, the intrinsic emetogenicity of the chemotherapy is the most important.…”

Section: Introductionmentioning

confidence: 99%

Incidence of chemotherapy-induced nausea and vomiting in Taiwan: physicians’ and nurses’ estimation vs. patients’ reported outcomes

Liau¹,

Chu

Liu

et al. 2005

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Medical providers significantly overestimated the incidence of acute vomiting by 20% and 18% in HEC and MEC patients, respectively. While they correctly estimated the rate of delayed vomiting in HEC patients, they underestimated it by 16% in MEC patients. With respect to nausea, medical providers correctly estimated rates of both acute and delayed nausea in HEC patients, but significantly underestimated rates of acute and delayed nausea by 16% and 30%, respectively, in MEC patients.

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Section: Introductionmentioning

confidence: 99%

Incidence of chemotherapy-induced nausea and vomiting in Taiwan: physicians’ and nurses’ estimation vs. patients’ reported outcomes

Liau¹,

Chu

Liu

et al. 2005

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“…Due to the mechanism hllp://www.kargcr.ch of action of cytotoxic agents, which prevent the growth and division of rapidly dividing cells, tumourigenesis is not the only system affected: rapidly dividing cells in the bone marrow, hair follicles and gut are also potential tar gets, resulting in mvelosuppression, hair loss and nausea and vomiting. Nausea and vomiting are ranked by patients as the most distressing side effects of chemotherapy [1], It has been estimated that nausea and vomiting occur in approx imately 70% of patients [2] and can result in 25-50% of patients delaying one or more scheduled courses of che motherapy or even refusing further treatment [3]. Cispla- tin is one of the most emetogenic chemotherapy agents, and in high doses can cause emesis in almost all patients.…”

Section: Introductionmentioning

confidence: 99%

Control of Acute Cisplatin-lnduced Emesis over Repeat Courses of Chemotherapy

Roila¹

1996

Oncology

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There have been few studies to determine whether the efficacy of antiemetics is maintained over repeated courses of cisplatin chemotherapy. Two large controlled studies have been undertaken by our group to address this issue. A comparison of the standard high-dose regimen of metoclopramide plus methylprednisolone versus a higher dose regimen of metoclopramide plus dexamethasone and diphenhydramine showed that the latter regimen was significantly more efficacious with regard to complete control of nausea and vomiting in chemotherapy-nai’ve patients. However, this difference was not maintained over repeated courses of chemotherapy. A comparison of metoclopramide and dexamethasone plus diphenhydramine with ondansetron plus dexamethasone showed that the ondansetron regimen provided even greater control of vomiting, which was maintained over subsequent cycles of chemotherapy. Various factors were analysed in both studies to determine whether they had any effect on treatment outcome. In general, age < 50 years, female gender, and higher doses of cisplatin were associated with an increased risk of emesis. However, the most significant prognostic factor was emesis response in the previous cycle. It is therefore important to aim for good antiemetic control in the first cycle of cisplatin chemotherapy.

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“…However, it has been estimated that these symptoms will occur in up to 70% of patients [15,17,24]. It is also well recognised that children (above the age of 5 years) are more prone to vomiting than adults [27,30].…”

Section: Introductionmentioning

confidence: 99%

Antiemetics in children receiving chemotherapy. MASCC/ESMO guideline update 2009

Jordan¹,

Roila

Molassiotis

et al. 2010

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Only a few studies have been carried out in children on the prevention of chemotherapy-induced nausea and vomiting (CINV). 5-HT 3 receptor antagonists have been shown to be more efficacious and less toxic than metoclopramide, phenothiazines and cannabinoids. Most dose studies are available for the 5-HT 3 receptor antagonists ondansetron and granisetron. The new 5-HT 3 receptor antagonist palonosetron was evaluated in one comparative study so far showing promising activity. Combinations of a 5-HT 3 receptor antagonist and dexamethasone showed increased efficacy with respect to a 5-HT 3 receptor antagonist alone. All paediatric patients receiving chemotherapy of high or moderate emetogenic potential should receive a combination of a 5-HT 3 receptor antagonist and dexamethasone to prevent acute emesis. No studies have specifically evaluated antiemetic drugs in the prevention of chemotherapy-induced delayed and anticipatory emesis in children. The role of the NK1 receptor antagonists in children has to be further investigated, although one small study is published so far, showing promising activity in the prevention of CINV with aprepitant. The new proposed guideline from the Multinational Association of Supportive Care in Cancer and the European Society of Clinical Oncology summarises the updated data from the literature and takes into consideration the existing guidelines.

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Chemotherapy-Related Nausea and Vomiting: Etiology and Management

Cited by 51 publications

References 24 publications

Incidence of chemotherapy-induced nausea and vomiting in Taiwan: physicians’ and nurses’ estimation vs. patients’ reported outcomes

Incidence of chemotherapy-induced nausea and vomiting in Taiwan: physicians’ and nurses’ estimation vs. patients’ reported outcomes

Control of Acute Cisplatin-lnduced Emesis over Repeat Courses of Chemotherapy

Antiemetics in children receiving chemotherapy. MASCC/ESMO guideline update 2009

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