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将营养、身体锻炼、心理社会支持和止吐药物整合到 CINV 管理中:通向成功的道路。

Integrating nutrition, physical exercise, psychosocial support and antiemetic drugs into CINV management: The road to success.

机构信息

Section of Innovation Biomedicine, Oncology Area, Department of Engineering for Innovation Medicine (DIMI), University of Verona, Italy.

UOC Oncologia Medica, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Medical Oncology, Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Roma, Italy.

出版信息

Crit Rev Oncol Hematol. 2024 Sep;201:104444. doi: 10.1016/j.critrevonc.2024.104444. Epub 2024 Jul 13.

Abstract

Over the years, advancements in antiemetic drugs have improved chemotherapy-induced nausea and vomiting (CINV) control. However, despite the antiemetics therapies, in a relevant number of adult patients (∼30 %), CINV is still persistent, leading to several complications, such as electrolyte imbalances, anorexia, and treatment discontinuation. Supportive care interventions have gained credibility in cancer care, helping to improve patients' psycho-physical condition, quality of life, and managing symptoms, including CINV. Physical exercise and tailored nutritional counseling have demonstrated benefits in reducing the severity of nausea and vomiting. Psychological intervention has been postulated as a key approach in controlling anticipatory nausea/vomiting, as well as acupuncture/acupressure has been shown to decrease nausea and vomiting after chemotherapy treatments. In the current review, we aim to provide a clinical update on current prophylactic and delayed antiemetic guidelines for CINV and an overview of the non-pharmacological interventions tested for alleviating CINV in patients with cancer.

摘要

多年来,止吐药物的进步改善了化疗引起的恶心和呕吐(CINV)的控制。然而,尽管有了止吐治疗,在相当数量的成年患者(约 30%)中,CINV 仍然持续存在,导致多种并发症,如电解质失衡、厌食和治疗中断。支持性护理干预在癌症护理中获得了可信度,有助于改善患者的身心状况、生活质量,并控制包括 CINV 在内的症状。体育锻炼和量身定制的营养咨询已被证明可减轻恶心和呕吐的严重程度。心理干预被认为是控制预期性恶心/呕吐的关键方法,而针刺/指压也被证明可减少化疗后的恶心和呕吐。在本次综述中,我们旨在提供关于 CINV 的当前预防性和延迟性止吐指南的临床更新,并概述已测试用于缓解癌症患者 CINV 的非药物干预措施。

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