Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South, 5000, Australia.
Oncology Supportive Care Consultant, Overland Park, KS, 66212, USA.
Support Care Cancer. 2023 Dec 19;32(1):37. doi: 10.1007/s00520-023-08223-2.
Review the literature to update the MASCC guidelines from 2016 for controlling nausea and vomiting with systemic cancer treatment of low and minimal emetic potential.
A working group performed a systematic literature review using Medline, Embase, and Scopus databases between June 2015 and January 2023 of the management of antiemetic prophylaxis for anticancer therapy of low or minimal emetic potential. A consensus committee reviewed recommendations and required a consensus of 67% or greater and a change in outcome of at least 10%.
Of 293 papers identified, 15 had information about managing systemic cancer treatment regimens of low or minimal emetic potential and/or compliance with previous management recommendations. No new evidence was reported that would change the current MASCC recommendations. No antiemetic prophylaxis is recommended for minimal emetic potential therapy, and single agents recommended for low emetic potential chemotherapy for acute emesis, but no prophylaxis is recommended for delayed emesis. Commonly, rescue medication includes antiemetics prescribed for the next higher level of emesis.
There is insufficient data to change the current guidelines. Future studies should seek to more accurately determine the risk of emesis with LEC beyond the emetogenicity of the chemotherapy to include patient-related risk assessment.
更新 MASCC 指南，对低和轻微致吐性的全身性癌症治疗的恶心和呕吐进行控制。
一个工作组使用 Medline、Embase 和 Scopus 数据库，对 2015 年 6 月至 2023 年 1 月期间低或轻微致吐性的癌症治疗的止吐预防管理进行了系统的文献回顾。共识委员会审查了建议，并要求达到至少 67%的共识和至少 10%的结果改变。
在确定的 293 篇论文中，有 15 篇论文提供了有关管理低或轻微致吐性全身性癌症治疗方案和/或遵守先前管理建议的信息。没有新的证据表明需要改变当前 MASCC 的建议。对于轻微致吐性治疗，不建议进行任何止吐预防，仅推荐用于低度致吐性化疗的单一药物预防急性呕吐，但不建议预防迟发性呕吐。通常，解救药物包括下一级呕吐的止吐药物。
目前的数据不足以改变现有指南。未来的研究应该寻求更准确地确定 LEC 除化疗致吐性以外的呕吐风险，包括患者相关的风险评估。
