肿瘤呕吐指南Mar 20.pptVIP

谢 谢! 发生CINV的概率主要取决于2个因素：患者特征和化疗——特异性因素。1 1. Navari RM. J Support Oncol. 2003;1(2):89–103. * The aprepitant triple-therapy is recommended for the acute phase of HEC, and the two combination including aprepitant for the delayed phase of HEC. These recommendation also suitable for the high risk MEC pts, who are receiving certain chemotherapy drugs, such as carbopaltin, cisplatin, doxorubicin, epirubicin, ifosfamide, irinotecan, or methotrexate, etc. The detailed information would be introduced in the medical MAP. Recent guidelines published incorporate recommendations for the use of EMEND and the newest 5-HT3 RA, palonosetron. Slide 15 presents the recommended treatment options based on the most recent American1,2 and European antiemetic guidelines.3 For patients receiving HEC guidelines recommend the use of 5-HT3 antagonists in combination with dexamethasone and EMEND in the acute (day 1) and delayed (days 2+) phases.1-3 Both NCCN and MASCC guidelines recommend IVEMEND in acute phase (day 1). However, if IVEMEND is used in acute phase no EMEND is recommended in the delayed phase. Guidelines for the prevention of CINV with MEC agents vary somewhat between guidelines. Guidelines from the NCCN1 recommend the use of EMEND both in acute and delayed phases of CINV whereas the ASCO guidelines2 recommend the use of EMEND only in regimens which include an anthracycline and cyclophosphamide. NCCN considers AC regimens as HEC while MASCC considers AC separately as a special “high risk” MEC. Guidelines from the MASCC3 recommend the use of EMEND in the delayed phase (as an alternative to dexamethasone or 5-HT3 receptor antagonist) for both AC and MEC regimens. References: National Comprehensive Cancer Network. Antiemesis Practice Guidelines Panel. NCCN Antiemetics Practice Guidelines. 2011. Kris MG, et al. American society of clinical oncology guideline for antiemetics in oncology: update 2006. J Clin Oncol 2006;24(18):2932-47. Roila F, et al. Guideline update for MASC