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Annals of Oncology Advance Access originally published online on November 28, 2005
Annals of Oncology 2006 17(1):20-28; doi:10.1093/annonc/mdj078
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© 2005 European Society for Medical Oncology

review

Prevention of chemotherapy- and radiotherapy-induced emesis: results of the 2004 Perugia International Antiemetic Consensus Conference

The Antiemetic Subcommittee of the Multinational Association of Supportive Care in Cancer (MASCC){dagger}

Medical Oncology Division, Silvestrini Hospital, Perugia, Italy

Correspondence to: Dr F. Roila, Medical Oncology Division, Silvestrini Hospital, 06156S. Andrea delle Fratte, Perugia, Italy. Tel: +39-349-2370722; Fax: +39-07-55784113; E-mail: roila.fausto{at}libero.it

Background: In the late 1990s, several professional organizations convened antiemetic guideline groups and published the findings of these expert panels. Each of these documents was based on analyses of the available published trials and provided nearly similar recommendations. Nonetheless, small differences in emetic risk categories and treatment recommendations led to confusion in antiemetics selection. With the emergence of new findings and agents since the guidelines were initially published, many of the oncology professional societies have updated the antiemetic guidelines.

Materials and methods: A literature review up to March 2004 was carried out using MEDLINE with evaluation of the evidence by an expert panel composed of 23 oncology professionals in clinical medicine, medical oncology, radiation oncology, oncology nursing, statistics, pharmacy, medical policy and decision making, and pharmacology. The experts represented nine oncology professional societies and came from 11 different countries on four continents.

Results: Recommendations on antiemetic regimens to prevent emesis induced by high, moderate, low and minimal risk chemotherapy were suggested as well as management of anticipatory emesis. Furthermore, recommendations for refractory emesis, emesis induced by high-dose chemotherapy and radiotherapy and for antiemetics in children receiving chemotherapy were elaborated.

Conclusions: Recommendations about antiemetic prophylaxis in patients receiving treatment with chemo- and radiotherapy have been updated by representatives of nine oncological organizations.

Key words: acute emesis, aprepitant, delayed emesis, dexamethasone, 5-HT3-receptor antagonists, metoclopramide


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