Allan S G
Medical Oncology Unit, Western General Hospital, Edinburgh.
Blood Rev. 1987 Mar;1(1):50-7. doi: 10.1016/0268-960x(87)90019-1.
Only in recent years has serious attention been given to the control of chemotherapy-induced emesis (CIE) which is to the patient a most obnoxious side-effect. Important advances in the understanding of the mechanisms of CIE have led to the scientific appraisal of potential anti-emetics whilst additional, useful anti-emetics have appeared by serendipity. CIE has largely been studied in trials separating either cis-platinum (severely emetic) or non-cis-platinum(moderately emetic)-induced emesis. In the evolution of these trials the difficulty and importance of accurate evaluation of emesis has been revealed and the whole area of psychogenic emesis opened to investigation and treatment. Phenothiazines and butyrophenones have a definite modest anti-emetic role against moderately emetogenic chemotherapy but increasingly corticosteroids, benzodiazepines, high dose metoclopramide and cannabinoids are being used with great effect even with severely emetic drugs. Combination anti-emesis has further improved control rates and new schedules of currently available anti-emetics are now proving their worth. Major advances in anti-emetic control have been achieved recently and every patient at risk of CIE should have good control, if not total abolition, of emesis with appropriate use of anti-emetics.
直到近年来，化疗引起的呕吐（CIE）才受到认真关注，而这对患者来说是一种极其令人厌恶的副作用。对CIE机制理解的重要进展促使人们对潜在的止吐药进行科学评估，同时偶然间也出现了其他有用的止吐药。CIE主要在区分顺铂（严重致吐）或非顺铂（中度致吐）引起的呕吐的试验中进行研究。在这些试验的发展过程中，已揭示出准确评估呕吐的难度和重要性，并且心理性呕吐这一整个领域也开始接受调查和治疗。吩噻嗪类和丁酰苯类药物对中度致吐性化疗有一定程度的适度止吐作用，但越来越多地使用皮质类固醇、苯二氮䓬类、高剂量甲氧氯普胺和大麻素，甚至对严重致吐药物也有很好的效果。联合使用止吐药进一步提高了控制率，目前可用的止吐药的新方案正在证明其价值。最近在止吐控制方面取得了重大进展，每一位有CIE风险的患者如果合理使用止吐药，呕吐即使不能完全消除，也应该得到很好的控制。
