Radiotherapy-induced nausea and vomiting Prophylaxis and 放疗引起的恶心与呕吐的预防.docVIP

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Radiotherapy-induced nausea and vomiting Prophylaxis and 放疗引起的恶心与呕吐的预防.doc

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Radiotherapy-induced nausea and vomiting Prophylaxis and 放疗引起的恶心与呕吐的预防

Radiotherapy-induced nausea and vomiting: Prophylaxis and treatment AuthorsPetra Feyer, MDMaria Steingr?ber, MDKarin Jordan, MD Section EditorsPaul J Hesketh, MDBrian Kavanagh, MD, MPH Deputy EditorMichael E Ross, MD Last literature review version 18.2: Maio 2010 | This topic last updated: Janeiro 26, 2010 (More) INTRODUCTION?—?Nausea and vomiting caused by radiation therapy (RT) are generally less severe than that caused by chemotherapy. However, these side effects are clinically important and can be distressing for patients. Furthermore, RT-induced nausea and vomiting (RINV) can cause patients to delay or refuse further treatment. The incidence, classification of risk, and management of RINV are discussed here. The approach to chemotherapy-induced nausea and vomiting are discussed separately. (See Prevention and treatment of chemotherapy-induced nausea and vomiting.) PATHOPHYSIOLOGY?—?The pathophysiology of RINV is incompletely understood but is thought to be similar to that caused by chemotherapy. Progress in understanding the pathophysiology of chemotherapy-induced emesis led to the development of agents that form the basis for treatment of RINV. (See Pathophysiology and prediction of chemotherapy-induced nausea and vomiting.) INCIDENCE?—?Two prospective observational studies provide information on the frequency of RINV and the extent to which this problem is treated: In a series of 368 patients receiving radiation therapy, the overall incidence rates for nausea and vomiting were 39 and 7 percent, respectively [1]. Nausea was more frequent in those receiving RT to the lower abdomen or pelvis and to the head and neck area (66 and 48 percent, respectively). Importantly, only one-fourth of the patients reporting nausea felt that antiemetics had been beneficial and one-third would have liked additional treatment. The Italian Group for Antiemetic Research in Radiotherapy (IGARR) analyzed the incidence of RINV in 1020 patients receiving various kinds of RT [2]