S. Maria Hospital, Terni, Italy.
Support Care Cancer. 2011 Mar;19 Suppl 1:S57-62. doi: 10.1007/s00520-010-1039-y. Epub 2010 Dec 5.
An update of the recommendations for the prophylaxis of delayed emesis induced by moderately emetogenic chemotherapy discussed during the third Perugia Consensus Conference (June 2009) sponsored by MASCC-ESMO was presented. The review considered new studies published since the second consensus conference (April 2004).
An online search was used conducting PubMed and the search terms moderately, chemotherapy, and emesis with a restriction to papers in English.
Overall, nine randomized controlled studies were included: four evaluating NK1 receptor antagonists, one palonosetron, and four dopamine receptor antagonists.
In patients receiving a combination of anthracycline plus cyclophosphamide treated with a combination of aprepitant, a 5-HT(3) receptor antagonist and dexamethasone to prevent acute nausea and vomiting, aprepitant is suggested to prevent delayed emesis. In patients who do not receive aprepitant for the prophylaxis for acute emesis and in which palonosetron is recommended, a multiday oral dexamethasone is the preferred treatment for the prevention of delayed emesis. Levels of evidence and of consensus for both recommendations are moderate.
对 2009 年 6 月 MASCC-ESMO 赞助的第三届佩鲁贾共识会议（第二届共识会议[2004 年 4 月]之后）讨论的中度致吐性化疗引起延迟性呕吐预防建议进行更新。本综述考虑了自第二届共识会议以来发表的新研究。
使用在线搜索，在 PubMed 上进行检索，检索词为中度、化疗和呕吐，并限制为英文论文。
共纳入 9 项随机对照研究：4 项评估 NK1 受体拮抗剂，1 项评估帕洛诺司琼，4 项评估多巴胺受体拮抗剂。
对于接受阿霉素加环磷酰胺联合治疗的患者，联合应用阿瑞匹坦、5-HT3 受体拮抗剂和地塞米松预防急性恶心和呕吐，建议应用阿瑞匹坦预防延迟性呕吐。对于未接受阿瑞匹坦预防急性呕吐且推荐应用帕洛诺司琼的患者，多日口服地塞米松是预防延迟性呕吐的首选治疗方法。这两项建议的证据水平和共识水平均为中级。
