Department of Radiotherapy, Nuclear Medicine, Vivantes Medical Center Berlin-Neukölln, Rudower Str. 48, 12351 Berlin, Germany.
Support Care Cancer. 2011 Mar;19 Suppl 1:S5-14. doi: 10.1007/s00520-010-0950-6. Epub 2010 Aug 10.
Radiation-induced nausea and vomiting (RINV) are still often underestimated by radiation oncologists. However, as many as 50-80% of patients undergoing radiotherapy (RT) will experience nausea and/or vomiting, depending on the site of irradiation. Fractionated RT may involve up to 40 fractions over a 6-8-week period, and prolonged symptoms of nausea and vomiting affect quality of life. Furthermore, uncontrolled nausea and vomiting may result in patients delaying or refusing further radiotherapy. Incidence and severity of nausea and vomiting depend on RT-related factors (irradiated site, single and total dose, fractionation, irradiated volume, radiotherapy techniques) and patient-related factors (gender, general health of the patient, age, concurrent or recent chemotherapy, psychological state, tumor stage). The new proposed guideline from the Multinational Association of Supportive Care in Cancer and European Society of Clinical Oncology summarises the updated data from the literature and takes into consideration the existing guidelines. According to the irradiated area (the most frequently studied risk factor), the proposed guideline divided these areas into four levels of emetogenic risk: high, moderate, low and minimal. In fact, the emetogenicity of radiotherapy regimens and recommendations for the appropriate use of antiemetics including 5-hydroxytryptamine receptor antagonists and steroids are given in regard to the applied radiotherapy or radiochemotherapy regimen. This updated guideline offers guidance to the treating physicians for effective antiemetic therapies in RINV.
放射性恶心和呕吐 (RINV) 仍然经常被放射肿瘤学家低估。然而，多达 50-80% 的接受放射治疗 (RT) 的患者会出现恶心和/或呕吐，具体取决于照射部位。分次 RT 可能涉及在 6-8 周内进行多达 40 次分割，并且恶心和呕吐的长期症状会影响生活质量。此外，不受控制的恶心和呕吐可能导致患者延迟或拒绝进一步的放射治疗。恶心和呕吐的发生率和严重程度取决于与 RT 相关的因素（照射部位、单次和总剂量、分割、照射体积、放射治疗技术）和患者相关的因素（性别、患者的整体健康状况、年龄、同时或近期化疗、心理状态、肿瘤分期）。支持癌症治疗的多国协会和欧洲临床肿瘤学会的新拟议指南总结了文献中的最新数据，并考虑了现有指南。根据照射区域（最常研究的危险因素），该拟议指南将这些区域分为四个致吐风险级别：高、中、低和最小。事实上，放射治疗方案的致吐性以及包括 5-羟色胺受体拮抗剂和类固醇在内的止吐药的适当使用建议是根据应用的放射治疗或放化疗方案给出的。该更新指南为治疗医生提供了在 RINV 中进行有效止吐治疗的指导。
