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癌症患儿急性化疗引起的恶心和呕吐:治疗仍有待达成共识。

Acute chemotherapy-induced nausea and vomiting in children with cancer: Still waiting for a common consensus on treatment.

作者信息

Ruggiero Antonio, Rizzo Daniela, Catalano Martina, Coccia Paola, Triarico Silvia, Attiná Giorgio

机构信息

1 Pediatric Oncology Unit, A. Gemelli Hospital, Catholic University of Rome, Rome, Italy.

2 Department of Paediatric Haemato-Oncology, Ospedale G. Salesi, Ancona, Italy.

出版信息

J Int Med Res. 2018 Jun;46(6):2149-2156. doi: 10.1177/0300060518765324. Epub 2018 Apr 24.

Abstract

Chemotherapy-induced nausea and vomiting (CINV) is one of the most common treatment side-effects, and remains a significant concern, in children undergoing chemotherapy. Although adult patients receive chemotherapy regimens combined with appropriate standardized antiemetic treatment, children can receive markedly varying antiemetic treatments. A narrative review of CINV was performed regarding CINV definition, scoring system, prevention and treatment, specifically focussing on studies conducted with paediatric oncology patients. The review highlighted a lack of rigorously developed CINV scoring systems and standardized CINV pharmacological treatment for paediatric oncology patients. Different scoring systems were found to identify potential risk factors for CINV associated with the use of several different antiemetic drugs, however, few studies have been performed in children undergoing chemotherapy. Thus, CINV remains a distressing and partially controlled side-effect in the paediatric patient population. To reduce emesis and improve quality of life in paediatric oncology patients, standardized antiemetic treatment may be preferred, using a unique CINV scoring system that accounts for the emetogenic level of the chemotherapy regimen adopted and the children's clinical characteristics.

摘要

化疗引起的恶心和呕吐(CINV)是最常见的治疗副作用之一,并且仍然是接受化疗的儿童的一个重大问题。尽管成年患者接受了联合适当标准化止吐治疗的化疗方案,但儿童接受的止吐治疗却明显不同。针对CINV的定义、评分系统、预防和治疗进行了一项叙述性综述,特别关注针对儿科肿瘤患者开展的研究。该综述强调,缺乏针对儿科肿瘤患者严格制定的CINV评分系统和标准化的CINV药物治疗。发现不同的评分系统可识别与使用几种不同止吐药物相关的CINV潜在风险因素,然而,针对接受化疗的儿童开展的研究很少。因此,CINV在儿科患者群体中仍然是一种令人痛苦且部分得到控制的副作用。为了减少呕吐并改善儿科肿瘤患者的生活质量,可能更倾向于采用标准化的止吐治疗,使用一种独特的CINV评分系统,该系统考虑到所采用化疗方案的致吐水平以及儿童的临床特征。

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