title: Latest advances in the management of radiation-induced pain flare, nausea and vomiting.
abstract: Palliative radiotherapy (RT) is an effective treatment for symptomatic bone metastases. However, pain flare, nausea and vomiting are common adverse effects associated with this treatment. The management of pain flare and radiation-induced nausea and vomiting (RINV) are important endpoints in palliative care. Our report documents the incidence, clinical importance, and advances in the management of these two adverse-effects. We recommend that antiemetic prophylaxis be given based on emetic risk category as outlined in the American Society of Clinical Oncology (ASCO) guidelines. Newer antiemetics investigated in the chemotherapy setting should also be studied in the radiation setting. As there are no guidelines for the use of pain flare prophylaxis at present, further research in this area is needed.
authors: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Nicholas
authors: N
authors: Chiu
authors: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Leonard
authors: L
authors: Chiu
authors: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Marko
authors: M
authors: Popovic
authors: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Carlo
authors: C
authors: DeAngelis
authors: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Mark
authors: M
authors: Pasetka
authors: Blanchard Valley Regional Cancer Center, Ohio, USA.
authors: Stephen
authors: S
authors: Lutz
authors: Liaoning Cancer Hospital & Institute, Shenyang, China.
authors: Na
authors: N
authors: Zhang
authors: Instituto do Câncer do Estado de São Paulo (ICESP)-Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil; Hospital Sírio-Libanês, Sao Paulo, Brazil.
authors: Gustavo Nader
authors: GN
authors: Marta
authors: Instituto do Câncer do Estado de São Paulo (ICESP)-Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil.
authors: Lucas Castro
authors: LC
authors: Mendez
authors: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Breanne
authors: B
authors: Lechner
authors: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Natalie
authors: N
authors: Pulenzas
authors: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Milica
authors: M
authors: Milakovic
authors: Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Ronald
authors: R
authors: Chow
authors: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada. Edward.Chow@sunnybrook.ca.
authors: Edward
authors: E
authors: Chow
mesh_terms: D000932:Antiemetics / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D003907:Dexamethasone / Q000627:therapeutic use; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use; D059352:Musculoskeletal Pain / Q000517:prevention & control*; D009325:Nausea / Q000517:prevention & control*; D017294:Ondansetron / Q000627:therapeutic use; D010166:Palliative Care / Q000379:methods; D011878:Radiotherapy / Q000009:adverse effects; D058831:Serotonin 5-HT3 Receptor Antagonists / Q000627:therapeutic use; D014839:Vomiting / Q000517:prevention & control*
chemical_list: D000932:Antiemetics; D058831:Serotonin 5-HT3 Receptor Antagonists; D017294:Ondansetron; D003907:Dexamethasone; D008775:Methylprednisolone
keywords: Antiemetics; nausea; pain flare; radiation; vomiting