Maranzano Ernesto, Feyer Petra Ch, Molassiotis Alexander, Rossi Romina, Clark-Snow Rebecca A, Olver Ian, Warr David, Schiavone Concetta, Roila Fausto
Radiation Oncology Centre, 'S. Maria' Hospital, Terni, Italy.
Radiother Oncol. 2005 Sep;76(3):227-33. doi: 10.1016/j.radonc.2005.07.002.
To report recommendations given in the Multinational Association of Supportive Care in Cancer (MASCC) International Consensus Conference regarding the use of antiemetics in radiotherapy.
A steering committee under MASCC auspice chose panel participants for the guidelines development process on prevention of chemotherapy- and radiotherapy-induced emesis (RIE). Pertinent information from published literature as of March 2004 was reviewed for the guideline process. Both the MASCC level of scientific confidence and level of consensus, and the American Society of Clinical Oncology (ASCO) type of evidence and grade for recommendation were adopted.
Total body irradiation is classified at high risk, upper abdomen at moderate, lower thorax, pelvis, cranium (radiosurgery) and craniospinal at low, head and neck, extremities, cranium and breast at minimal risk. The recommendations for the use of antiemetics in radiotherapy are as follows: prophylaxis with a 5-HT3 antagonist in patients at high and moderate risk levels of RIE (+/-dexamethasone in the former group), prophylaxis or rescue with a 5-HT3 antagonist in the low risk group, and rescue with dopamine or a 5-HT3 receptor antagonist in minimal risk level.
These recommendations represent a valid tool for prophylaxis and treatment of RIE in clinical practice.
报告癌症支持治疗多国协会（MASCC）国际共识会议中给出的关于放疗中使用止吐药的建议。
在MASCC主持下的一个指导委员会挑选了参与化疗和放疗所致呕吐（RIE）预防指南制定过程的小组成员。为该指南制定过程回顾了截至2004年3月已发表文献中的相关信息。采用了MASCC的科学置信水平和共识水平，以及美国临床肿瘤学会（ASCO）的证据类型和推荐等级。
全身照射被归类为高风险，上腹部为中度风险，下胸部、骨盆、颅骨（放射外科）和全脑脊髓为低风险，头颈部、四肢、颅骨和乳腺为极低风险。放疗中使用止吐药的建议如下：高风险和中度风险RIE患者使用5 - HT3拮抗剂进行预防（前一组可加用或不加用地塞米松），低风险组使用5 - HT3拮抗剂进行预防或解救，极低风险水平使用多巴胺或5 - HT3受体拮抗剂进行解救。
这些建议是临床实践中预防和治疗RIE的有效工具。
