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Lee and Kwon: Prophylactic antiemetics therapy against gynecologic cancer chemotherapy
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Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(3): 127-131.

Published online: 16 March 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.3.127

Prophylactic antiemetics therapy against gynecologic cancer chemotherapy

Keun Ho Lee, MD1, Yong Il Kwon, MD2

1Department of Obstetrics & Gynecology, The Catholic University of Korea School of Medicine, Seoul, Korea.

2Department of Obstetrics & Gynecology, Hallym University School of Medicine, Seoul, Korea.

Corresponding author: Yong Il Kwon, MD. Department of Obstetrics & Gynecology, Kangdong Sacred Heart Hospital, 445 Gil-dong, Gangdong-gu, Seoul 134-701, Korea. Tel: +82-2-2224-2259, Fax: +82-2-2224-2265, kbgy@hallym.or.kr

Received 19 October 2010       Accepted 31 January 2011

Copyright © 2011. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Nausea and vomiting associated with gynecologic cancer chemotherapy are experienced by most of patients receiving chemotherapy. Assessment of vomiting risk by chemotherapy and risk factor are mandatory for rescue of chemotherapy induced nausea and vomiting (CINV). Piled-up evidence based medicine result in prophylactic antiemetics guideline from American Society of Clinical Oncology, Multinational Association for Supportive Care in Cancer, and National Comprehensive Cancer Network. Combination of serotonin receptor antagonist, dexamethason, and with/without NK1 antagonist is the best prophylaxis in patients receiving highly and moderate emetogenic chemotherapy. Other new regimens (palonosetron, transdermal granisetron) are introduced to relieve the active symptom of delayed CINV. Comprehensive understading of pathophysiology of CINV and tailored therapy for the patients are vital in prophylactic antiemetics therapy against gynecologic cancer chemotherapy.

Keywords: Nausea, Vomiting, Antiemetics, Guideline

Figures and Tables

Table 1
IV antiemetics classified as emetic risk (From Hesketh PJ. N Engl J Med 2008;358:2482-94, with permission from New England Journal of Medicine. [3])
kjog-54-127-i001
Table 2
Administration guideline of antiemetics by NCCN & MASCC
kjog-54-127-i002

NCCN, National Comprehensive Cancer Network; MASCC, Multinational Association for Supportive Care in Cancer; 5-HT3, serotonin receptor antagonist; DEX, dexamethasone; APR, aprepitant.

*Specified palonosetron in MASCC guideline, †additional APR in NCCN guideline.

Table 3
Treatment options of breakthrough CINV (NCCN)
kjog-54-127-i003

CINV, chemotherapy induced nausea and vomiting; NCCN, National Comprehensive Cancer Network; 5-HT3, serotonin receptor antagonist.

Notes

Th is information was announced in 13th Educational lectures of Korean Society of Obstetrics and Gynecology at September 30, 2010.

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