2016 updated MASCC/ESMO consensus recommendations: Prevention of acute chemotherapy-induced nausea and vomiting in children
2016 updated MASCC/ESMO consensus recommendations: Prevention of acute chemotherapy-induced nausea and vomiting in children
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DOI：
10.1007/s00520-016-3384-y
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发表时间：
2017-01-01
影响因子：
3.1
通讯作者：
van de Wetering, Marianne
中科院分区：
文献类型：
--
作者：
Dupuis, L. Lee;Sung, Lillian;van de Wetering, Marianne
为了更新2009年关于预防儿童急性化疗所致呕吐的建议，我们更新了最初的系统性文献检索。如果随机化研究是以英文或法文全文完全发表的主要研究，则将其纳入支持本指南的证据中;仅纳入18岁以下的儿童，或对于成人和儿童的混合研究，单独报告儿科结果或中位或平均年龄不超过13岁;评价急性化疗诱导的恶心和呕吐（CINV）预防;提供足够的信息，以确定给予的化疗的致吐性，或研究者说明给予的化疗的致吐性;包括完全急性CINV反应的隐含或明确定义;完整描述止吐方案;并报告了CINV急性完全缓解率的比例。25项随机研究（包括自2009年以来发表的8项）符合本系统评价的纳入标准。对于接受高度或中度致吐化疗的儿童，建议使用5-HT 3拮抗剂（格拉司琼或昂丹司琼或帕洛诺司琼或托烷司琼）+/- A地塞米松+/- A阿瑞匹坦进行预防。对于接受低致吐性化疗的儿童，推荐使用5-HT 3拮抗剂。几项随机试验的结果被用来更新预防急性CINV的建议。然而，重大的研究差距仍然存在，必须解决之前，CINV控制儿童可以优化。
To update the 2009 recommendations for the prevention of acute chemotherapy-induced emesis in children.We updated the original systematic literature search. Randomized studies were included in the evidence to support this guideline if they were primary studies fully published in full text in English or French; included only children less than 18 years old or, for mixed studies of adults and children, reported the pediatric results separately or the median or mean age was no more than 13 years; evaluated acute chemotherapy-induced nausea and vomiting (CINV) prophylaxis; provided sufficient information to permit determination of the emetogenicity of the antineoplastic therapy administered or the study investigators stated the emetogenicity of the chemotherapy administered; included an implicit or explicit definition of complete acute CINV response; described the antiemetic regimen in full; and reported the complete acute CINV response rate as a proportion.Twenty-five randomized studies, including eight published since 2009, met the criteria for inclusion in this systematic review. Prophylaxis with a 5-HT3 antagonist (granisetron or ondansetron or palonosetron or tropisetron) +/- A dexamethasone +/- A aprepitant is recommended for children receiving highly or moderately emetogenic chemotherapy. For children receiving chemotherapy of low emetogenicity, a 5-HT3 antagonist is recommended.The findings of several randomized trials were used to update recommendations for the prevention of acute CINV. However, significant research gaps remain and must be addressed before CINV control in children can be optimized.