For persons receiving chemotherapy of high emetic risk , there is no group of patients for whom agents of lower therapeutic index are appropriate first-choice antiemetics .
In all patients receiving cisplatin and all other agents of high emetic risk , the two-drug combination of dexamethasone and aprepitant is recommended for the prevention of delayed emesis .
The Up date Committee no longer recommends the combination of a 5-HT3 serotonin receptor antagonist and dexamethasone for the prevention of delayed emesis after chemotherapeutic agents of high emetic risk .
PURPOSE To up date the 1999 American Society of Clinical Oncology guideline for antiemetics in oncology .
Nausea and vomiting in fractionated radiotherapy: a prospective on-demand trial of tropisetron rescue for non-responders to metoclopramide.
A prospect i ve trial was performed to better assess the risk of nausea and vomiting and the rescue value of tropisetron ( TRO ) , a 5-HT3 receptor antagonist , in 88 patients undergoing fractionated radiotherapy to the abdomen or to large supradiaphragmatic fields and failing a first anti-emetic trial with metoclopramide ( MET ) .  Nausea was grade d 0 ( absent ) , 1 ( mild ) , 2 ( moderate ) and 3 ( severe ) . Nausea requiring anti-emetics ( > or = grade 2 ) was present in 64 % of the patients . MET was able to control nausea ( < or = grade 1 ) in 26 of 58 patients ( 45 % ) who developed > or = grade 2 nausea during radiation treatment ( 2 patients vomiting without nausea included ) . 34 patients required TRO , and 31 experienced immediate relief . However , nausea ( > or = grade 2 ) recurred in 7 patients from 1 to 3 weeks after starting TRO . Sex , age , field type and field size ( cm2 ) did not influence the incidence and severity of nausea and vomiting . Only 24/88 patients vomited after starting radiotherapy . MET helped to eliminate emesis in one third of these patients . TRO helped to control vomiting in 73 % of the salvaged patients . Constipation was observed in 8 patients on TRO and was a reason to stop the medication in 4 cases
For persons receiving chemotherapy of high emetic risk , there is no group of patients for whom agents of lower therapeutic index are appropriate first-choice antiemetics .
In all patients receiving cisplatin and all other agents of high emetic risk , the two-drug combination of dexamethasone and aprepitant is recommended for the prevention of delayed emesis .
The Up date Committee no longer recommends the combination of a 5-HT3 serotonin receptor antagonist and dexamethasone for the prevention of delayed emesis after chemotherapeutic agents of high emetic risk .
PURPOSE To up date the 1999 American Society of Clinical Oncology guideline for antiemetics in oncology .