Fauser A A, Fellhauer M, Hoffmann M, Link H, Schlimok G, Gralla R J
Clinic of BMT, Haematology and Oncology, Idar-Oberstein, Germany.
Eur J Cancer. 1999 Mar;35(3):361-70. doi: 10.1016/s0959-8049(98)00417-1.
Anti-emetic therapy has become integral to the management of patients with cancer. Goals related to complete emesis control include providing treatment that reduces hospitalisation and time in the ambulatory setting, care that is convenient for the patient and therapy that enhances patients' quality of life. A panel of clinical, health economic and basic scientists with expertise in various oncology disciplines reviewed published literature to develop evidence-based consensus guidelines for the prevention and treatment of chemotherapy-induced emesis. Currently, serotonin receptor antagonists and corticosteroids are the two categories of anti-emetics that are most effective, have the fewest side-effects and are convenient to use. These agents are recommended in combination for highly emetogenic chemotherapy regimens and as single agents or in combination for moderately to highly emetogenic chemotherapy. When possible, these agents may be given orally in single doses; current evidence does not support dose escalation for either category of anti-emetics. In special situations, such as the use of high-dose chemotherapy combination regimens, the most emetogenic component of the regimen should dictate the choice of anti-emetic. Appropriate anti-emetic use described in these guidelines represents both good medical practice and a sensible economic approach to care.
止吐治疗已成为癌症患者管理的重要组成部分。与完全控制呕吐相关的目标包括提供减少住院时间和门诊时间的治疗、为患者提供便利的护理以及提高患者生活质量的治疗。一组在各种肿瘤学学科方面具有专业知识的临床、卫生经济学和基础科学家对已发表的文献进行了综述，以制定基于证据的化疗引起的呕吐预防和治疗共识指南。目前，5-羟色胺受体拮抗剂和皮质类固醇是两类最有效的止吐药，副作用最少且使用方便。这些药物被推荐联合用于高度致吐性化疗方案，以及作为单一药物或联合用于中度至高度致吐性化疗。如有可能，这些药物可单剂量口服给药；目前的证据不支持这两类止吐药的剂量增加。在特殊情况下，如使用高剂量化疗联合方案时，方案中最具致吐性的成分应决定止吐药的选择。这些指南中描述的适当止吐药使用既代表了良好的医疗实践，也是一种明智的经济护理方法。
