Clemmons Amber, Gandhi Arpita, Clarke Andrea, Jimenez Sarah, Le Thuy, Ajebo Germame
University of Georgia College of Pharmacy, Augusta, Georgia.
Augusta University Medical Center, Augusta, Georgia.
J Adv Pract Oncol. 2021 Nov;12(8):810-832. doi: 10.6004/jadpro.2021.12.8.4. Epub 2021 Nov 1.
Chemotherapeutic agents and radiation therapy are associated with numerous potential adverse events (AEs). Many of these common AEs, namely chemotherapy- or radiation-induced nausea and vomiting, hypersensitivity reactions, and edema, can lead to deleterious outcomes (such as treatment nonadherence or cessation, or poor clinical outcomes) if not prevented appropriately. The occurrence and severity of these AEs can be prevented with the correct prescribing of prophylactic medications, often called "premedications." The advanced practitioner in hematology/oncology should have a good understanding of which chemotherapeutic agents are known to place patients at risk for these adverse events as well as be able to determine appropriate prophylactic medications to employ in the prevention of these adverse events. While several guidelines and literature exist regarding best practices for prophylaxis strategies, differences among guidelines and quality of data should be explored in order to accurately implement patient-specific recommendations. Herein, we review the existing literature for prophylaxis and summarize best practices.
化疗药物和放射治疗会引发众多潜在不良事件(AE)。这些常见不良事件中的许多,即化疗或放疗引起的恶心和呕吐、过敏反应以及水肿,如果未得到适当预防,可能会导致有害后果(如治疗依从性差或中断,或临床预后不佳)。通过正确开具预防性药物(通常称为“预处理药物”),可以预防这些不良事件的发生和严重程度。血液学/肿瘤学领域的高级从业者应充分了解哪些化疗药物会使患者面临这些不良事件的风险,并且能够确定用于预防这些不良事件的适当预防性药物。虽然存在一些关于预防策略最佳实践的指南和文献,但应探究指南之间的差异以及数据质量,以便准确实施针对特定患者的建议。在此,我们回顾现有预防文献并总结最佳实践。