title: [Incidence and treatment of chemotherapy-induced nausea and emesis in gastrointestinal cancer].
abstract: The incidence of gastrointestinal (GI) cancer is increasing, with approximately 2 million new cases diagnosed worldwide and about 1.2 million patients dying per year. In Europe, about 500 ,000 people per year are newly diagnosed with GI cancer. The most frequent cancer types that undergo chemotherapy include cancer of the oesophagus, stomach, pancreas, biliary tract and colorectum. In the last years, various new agents and combinations have been demonstrated to improve the prognosis of patients with GI cancer. However, with the introduction of new and more effective systemic treatments, the need for supportive treatment has become more complex. There has been significant improvement in the management of nausea and vomiting arising from highly and moderately emetogenic chemotherapy. Nevertheless, vomiting and especially nausea continue to be two of the most distressing side effects of antineoplastic treatment. For the prevention of chemotherapy-induced nausea and vomiting in highly emetogenic therapy, a triple therapy including a 5-HT3-receptor antagonist (RA), dexamethasone and an NK1-RA, aprepitant or fosaprepitant are recommended. In moderately emetogenic regimens, updated guidelines recommend the combination of the second-generation 5-HT3-RA palonosetron with dexamethasone, providing improved protection against acute nausea and vomiting, and demonstrating superior prevention in the delayed phase. This review provides an update of the revised clinical guidelines for antiemetic treatment and prophylaxis in GI cancer patients receiving chemotherapy.
authors.affiliation: 3rd Department of Internal Medicine (Hematology/Oncology), Klinikum rechts der Isar, Technische Universität München.
authors.forename: S
authors.initials: S
authors.lastname: Lorenzen
authors.affiliation: 3rd Department of Internal Medicine (Hematology/Oncology), Klinikum rechts der Isar, Technische Universität München.
authors.forename: S
authors.initials: S
authors.lastname: Spörl
authors.affiliation: University Cancer Center Leipzig (UCCL), University Clinic Leipzig.
authors.forename: F
authors.initials: F
authors.lastname: Lordick
mesh_terms: D000932:Antiemetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D019983:Guideline Adherence; D006801:Humans; D015994:Incidence; D009325:Nausea / Q000139:chemically induced* / Q000188:drug therapy* / Q000453:epidemiology; D012307:Risk Factors; D014839:Vomiting / Q000139:chemically induced* / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents