Radiotherapy-induced nausea and vomiting (RINV): MASCC/ESMO guideline for antiemetics in radiotherapy: update 2009
Radiotherapy-induced nausea and vomiting (RINV): MASCC/ESMO guideline for antiemetics in radiotherapy: update 2009
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DOI：
10.1007/s00520-010-0950-6
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发表时间：
2011-03-01
影响因子：
3.1
通讯作者：
Jordan, Karin
中科院分区：
文献类型：
--
作者：
Feyer, Petra Christine;Maranzano, Ernesto;Jordan, Karin
放射引起的恶心和呕吐（RINV）仍然经常被放射肿瘤学家低估。然而，多达50-80%的接受放射治疗（RT）的患者将经历恶心和/或呕吐，这取决于照射部位。分次RT可能在6-8周内涉及多达40个部分，并且恶心和呕吐的长期症状影响生活质量。此外，不受控制的恶心和呕吐可能导致患者延迟或拒绝进一步的放射治疗。恶心和呕吐的发生率和严重程度取决于RT相关因素（辐照部位、单次和总剂量、分次、辐照体积、放疗技术）和患者相关因素（性别、患者的一般健康状况、年龄、同时或近期化疗、心理状态、肿瘤分期）。多国癌症支持治疗协会和欧洲临床肿瘤学会的新指南总结了文献中的最新数据，并考虑了现有指南。根据受辐照地区（最经常研究的风险因素），拟议准则将这些地区分为四个致吐风险等级：高、中、低和最低。事实上，放射治疗方案的致吐性和适当使用止吐药（包括5-羟色胺受体拮抗剂和类固醇）的建议与应用的放射治疗或放射化疗方案有关。本更新指南为治疗医生提供了RINV有效止吐治疗的指导。
Radiation-induced nausea and vomiting (RINV) are still often underestimated by radiation oncologists. However, as many as 50-80% of patients undergoing radiotherapy (RT) will experience nausea and/or vomiting, depending on the site of irradiation. Fractionated RT may involve up to 40 fractions over a 6-8-week period, and prolonged symptoms of nausea and vomiting affect quality of life. Furthermore, uncontrolled nausea and vomiting may result in patients delaying or refusing further radiotherapy. Incidence and severity of nausea and vomiting depend on RT-related factors (irradiated site, single and total dose, fractionation, irradiated volume, radiotherapy techniques) and patient-related factors (gender, general health of the patient, age, concurrent or recent chemotherapy, psychological state, tumor stage). The new proposed guideline from the Multinational Association of Supportive Care in Cancer and European Society of Clinical Oncology summarises the updated data from the literature and takes into consideration the existing guidelines. According to the irradiated area (the most frequently studied risk factor), the proposed guideline divided these areas into four levels of emetogenic risk: high, moderate, low and minimal. In fact, the emetogenicity of radiotherapy regimens and recommendations for the appropriate use of antiemetics including 5-hydroxytryptamine receptor antagonists and steroids are given in regard to the applied radiotherapy or radio-chemotherapy regimen. This updated guideline offers guidance to the treating physicians for effective antiemetic therapies in RINV.