【2017年整理】乳腺癌化疗之恶心呕吐.pptVIP

乳腺癌化疗毒副作用 阜阳市肿瘤医院 Breast cancer chemotherapy side effects Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 恶心、呕吐 腹泻 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 肿瘤治疗相关性呕吐 3 伴随肿瘤治疗过程中发生 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 伴随症状及影响 轻微：不适感 重度：脱水、电解质紊乱、营养不良、胃肠道粘膜撕裂出血 治疗依从性降低 治疗贻误 终止有效治疗 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. CONTENTS Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. CINV分类 急性呕吐 化疗后24h内发生 延迟性呕吐 化疗后24h or 更长时间 预期性呕吐 曾有CINV经历，化疗前、中、后发生 突破性呕吐 预防处理后发生 难治性呕吐 CINV预防、解救治疗失败 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 预期性呕吐 Anticipatory 急性呕吐 Acute 迟发性呕吐 Delayed 化疗 24 hours 突破性呕吐：预防处理好转后再次发生的严重恶心呕吐 难治性呕吐：CINV预防和解救措施失败 具有中高度催吐的化疗引起的 恶心呕吐反应至少持续3天 CINV类型 Chemotherapy-Induced Nausea and Vomiting (CINV):化疗导致的恶心呕吐 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 2004年意大利佩鲁贾会议达成共识 先后被MASCC / NCCN / ASCO 所采用 HIGH 高度致吐风险 90% MODERATE 中度致吐风险 30-90% LOW 轻度致吐风险 10-30% MINIMAL 轻微致吐风险 10% 蒽环类+环磷酰胺(AC/EC) 环磷酰胺 1500 mg/m2 顺铂 ≥ 50 mg/m2 蒽环类 环磷酰胺≤1500 mg/m2 异环磷酰胺 顺铂 50 mg/m2 卡铂 奥沙利铂 75 mg/m2 伊立替康 紫杉醇 多西他赛 (iv 口服) 白蛋白结合型紫杉醇 吉西他滨 5-Fu 多柔比星脂质体 培美曲塞 VP-16 西妥昔单抗 赫赛汀(曲妥珠单抗) 贝伐单抗 吉非替尼 索拉非尼 希罗达(卡培他滨) PRN推荐(口服抗肿瘤药) Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. HIGH (高度致吐风险) MODERATE (中度致吐风险) AC方案(蒽环类+环磷酰胺) 顺铂 ≥ 50 mg/m2 环磷酰胺 1500 mg/m2 卡莫司汀 250 mg/m2 六甲蜜胺 达卡巴嗪