緩和ケアと医学

抽象的な

Nausea and Vomiting in Cancer Patients: Topic Review

Nagwa A.E. Ibrahim

Nausea and vomiting are known side effects for cancer therapy. The prevalence is around 40-80%. The level of emetoginicity varies based on different factors. The potential receptors involved in emesis pathway are dopamine receptors, 5-hydroxytryptamine type 3 receptors and neurokinin receptors. The main guidelines for prevention of nausea and vomiting are ASCO, NCCN, MASCC/ESMO. These guidelines recommend three antiemetic drugs for highly emetic chemotherapy and two antiemetic drugs for moderately emetic chemotherapy. While for low risk regimens single antiemetic might be used and for minimal risk regimens antiemetic is not routinely recommended. Non pharmacological therapy might be considered as well. There are different tools for assessment of nausea and vomiting such as EORTC-QLQ-C30 and FACT-G. The Multinational Association of Supportive Care in Cancer (MASCC) tool individually address both acute and delayed nausea and vomiting, available in different languages and has iPhone/iPad application. Proper prevention of this side effect is highly recommended to improve patient quality of life, to avoid further complications as dehydration, electrolyte imbalance and to ensure continuation of treatment plan.