Department of Medical Oncology and Hematology, University of Halle, Ernst Grube Strasse 40, Halle, Germany.
Support Care Cancer. 2011 Mar;19 Suppl 1:S37-42. doi: 10.1007/s00520-010-0994-7. Epub 2010 Sep 9.
Only a few studies have been carried out in children on the prevention of chemotherapy-induced nausea and vomiting (CINV). 5-HT(3) receptor antagonists have been shown to be more efficacious and less toxic than metoclopramide, phenothiazines and cannabinoids. Most dose studies are available for the 5-HT(3) receptor antagonists ondansetron and granisetron. The new 5-HT(3) receptor antagonist palonosetron was evaluated in one comparative study so far showing promising activity. Combinations of a 5-HT(3) receptor antagonist and dexamethasone showed increased efficacy with respect to a 5-HT(3) receptor antagonist alone. All paediatric patients receiving chemotherapy of high or moderate emetogenic potential should receive a combination of a 5-HT(3) receptor antagonist and dexamethasone to prevent acute emesis. No studies have specifically evaluated antiemetic drugs in the prevention of chemotherapy-induced delayed and anticipatory emesis in children. The role of the NK1 receptor antagonists in children has to be further investigated, although one small study is published so far, showing promising activity in the prevention of CINV with aprepitant. The new proposed guideline from the Multinational Association of Supportive Care in Cancer and the European Society of Clinical Oncology summarises the updated data from the literature and takes into consideration the existing guidelines.
仅有少数研究在儿童中开展了预防化疗引起的恶心和呕吐（CINV）的研究。5-HT3 受体拮抗剂比甲氧氯普胺、吩噻嗪类和大麻素更有效且毒性更小。大多数剂量研究都可用于 5-HT3 受体拮抗剂昂丹司琼和格拉司琼。迄今为止，仅有一项比较研究评估了新型 5-HT3 受体拮抗剂帕洛诺司琼，结果显示出有前景的活性。5-HT3 受体拮抗剂与地塞米松联合使用在预防急性呕吐方面显示出比单独使用 5-HT3 受体拮抗剂更高的疗效。所有接受高或中度致吐性化疗的儿科患者均应接受 5-HT3 受体拮抗剂和地塞米松的联合治疗以预防急性呕吐。尚无研究专门评估止吐药物在预防儿童化疗引起的迟发性和预期性呕吐中的作用。NK1 受体拮抗剂在儿童中的作用尚需进一步研究，尽管迄今为止仅有一项小型研究发表，显示阿瑞匹坦在预防 CINV 方面具有有前景的活性。癌症支持治疗多国协会和欧洲临床肿瘤学会的新建议指南总结了文献中的更新数据，并考虑了现有指南。
