止吐药和全程管理.ppt

上落大字 SHANGHAI JIAD TON 止吐药物合理应用与化疗相关性 呕吐的全程管理 Chemotherapy-Induced Naucia and Vomiting 上海市第六人民匪眈 hanghai Sixth Peaples Hospital-  上落通大字 当今国内外主要止吐指南知多少 SIIANGHIAI JIAQ TONG UNIVERSIY ■国际: 癌症支持疗法多国学会( Multinational Association of Supportive Care in Cancer, MASCC) 欧洲肿瘤内科学会( European Society for Medical Oncology,ESMo) 一美国 国立综合性癌症网络( National Comprehensive Cancer Network,NCN止吐指南√ 美国临床肿瘤学会( American Society of Clinical Oncology,ASCO)止吐指南 ■欧洲:(2013版) SEoM( Spanish Society of Medical Oncology ■中国:(2014版) 比较结果:大同小异 中国抗癌协会癌症康复与姑息治疗专业委员会 (The Committee of Rehabilitation and Palliative Care, CRPC) 中国临床肿瘤学会抗肿瘤药物安全管理专家委员会 - (Antitumor drug safety management committee, ASMc) 上海市第六人民医院 Shanghai sixth Peoples Hospita  上落通大字 SIIANGHIAI JIAQ TONG UNIVERSIY 关于致吐药物的最新分类 峰市第六人民医院 院種  (热)上交更大 National Comprehensive NCCN Guidelines version 1, 2015 NCCN Guide ines index NCCN Cancet Antiemesis Anijemes s able cf contents Discussion EMETOGENIC POTENTIAL OF INTRAVENOUS ANTINEOPLAS TIC AGENISY 静脉用药 High emetic risk AC combination defined as either Cyclophosphamide 1, 500 mg m Epirubicin 90 mg - m 90% frequency of emesis)N. a doxorubicin or epirubicin with .Dacarbazine nide 22 gm per dose 高致吐药物 cydophosphamidey Doxorubicin 60 mar Carmustine 250 mgn STreptozocin .Aldesleukin 12-15million IUm.Clofarabine Ifosfamide2 gmp per dose (30%-90% frequency of emesis x Amifostine 300 mgm= .Interferon ala Iron Iu/m Cytarabine 200 maim? Irinote cany .Azacitidine Daunomycin Melphalan bendamustine Daunorubicin 中致吐药物 Methotrexate 250 mam Busulfan Doxorubicin 60 mgIT Carboplatin Epirubicin $90 mgms Temozolamide armustiney$250 mgm larubicr Grunberg SM, War D, Gralla RJ, et al. Evaluaton of new antemete agents and definition of antmeopla Shanghal sixth Peoples Hospital  Comprehensive NCCN Guidelines Version 1.2015 nCCN Cande Networ Antiemesis DiscussIO EMETOGENIC POTENTIAL OF INTRAVENCUS ANTINEOPLASTIC AGENTSY 静脉用药 trastuzumab emtansin