2016 updated MASCC/ESMO consensus recommendations: prevention of radiotherapy-induced nausea and vomiting

Christina H. Ruhlmann*, Franziska Jahn, Karin Jordan, Kristopher Dennis, Ernesto Maranzano, Alexander Molassiotis, Fausto Roila, Petra Feyer

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Purpose: Radiotherapy-induced nausea and vomiting (RINV) are distressing symptoms. Evidence-based guidelines should facilitate the prescription of the best possible antiemetic prophylaxis. As part of the MASCC/ESMO Antiemetic Guidelines Update 2016, a thorough review of the literature concerning RINV since the 2009 update was required. Methods: A systematic review of the literature including data published from June 2009 to May 2015 was performed. Committee VII (RINV) under the MASCC/ESMO Antiemetic Guidelines Update Committee assessed the literature. Results: The searches yielded 926 records, 906 records were excluded, leaving 20 records for full text assessment, and 18 publications were finally included. The only fully published randomized studies in prevention of RINV were two negative studies in acupuncture and green tea, respectively. No data to support new recommendations for antiemetic prophylaxis in RINV was available. However, based on expert opinions, the committee agreed on changes in emetic risk level for certain sites of irradiation. Conclusions: The serotonin receptor antagonists are still the corner stone in antiemetic prophylaxis of nausea and vomiting induced by high and moderate emetic risk radiotherapy. The studies available since the last update did not change recommendations for antiemetic prophylaxis. The emetogenicity of craniospinal radiotherapy was reclassified from low to moderate emetic level along with some other minor changes. In the future, RINV prophylaxis in single fraction, multiple fraction, and in concomitant chemo-radiotherapy still need to be explored with regard to the different classes and combinations of antiemetic drugs.

Original languageEnglish
JournalSupportive Care in Cancer
Volume25
Issue number1
Pages (from-to)309-316
ISSN0941-4355
DOIs
Publication statusPublished - Jan 2017

Keywords

  • Antiemetics
  • Guideline
  • Nausea
  • Radiotherapy
  • Vomiting
  • Vomiting/etiology
  • Humans
  • Risk
  • Consensus
  • Randomized Controlled Trials as Topic
  • Radiotherapy/adverse effects
  • Radiation Injuries/prevention & control
  • Nausea/etiology
  • Antiemetics/therapeutic use
  • Practice Guidelines as Topic

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