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



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.



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.



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.
Department of Oncology, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense C, Denmark. c.ruhlmann@dadlnet.dk.
Christina H
CH
Ruhlmann
Department of Hematology and Oncology, Martin-Luther University Halle-Wittenberg, Halle, Germany University of Halle, Ernst Grube Strasse 40, Halle, Germany.
Franziska
F
Jahn
Department of Hematology and Oncology, Martin-Luther University Halle-Wittenberg, Halle, Germany University of Halle, Ernst Grube Strasse 40, Halle, Germany.
Karin
K
Jordan
Division of Radiation Oncology, Ottawa Hospital Research Institute, University of Ottawa, 501 Smyth Road, Ottawa, Ontario, K1H8L6, Canada.
Kristopher
K
Dennis
Departement of Oncology, Radiation Oncology Centre, Azienda Ospedaliera S. Maria, Via T. di Joannuccio 1, 05100, Terni, Italy.
Ernesto
E
Maranzano
School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong, China.
Alexander
A
Molassiotis
Departement of Oncology, Medical Oncology Division, Azienda Ospedaliera S. Maria, Via T. di Joannuccio 1, 05100, Terni, Italy.
Fausto
F
Roila
Department of Radiation Oncology, Vivantes Clinics Neukoelln, Rudower Str. 48, 12351, Berlin, Germany.
Petra
P
Feyer
D000932:Antiemetics / Q000627:therapeutic use*; D006801:Humans; D009325:Nausea / Q000209:etiology* / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011832:Radiation Injuries / Q000517:prevention & control*; D011878:Radiotherapy / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D014839:Vomiting / Q000209:etiology* / Q000517:prevention & control*
D000932:Antiemetics
Antiemetics; Guideline; Nausea; Radiotherapy; Vomiting