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Radiotherapy-induced nausea and vomiting (RINV): antiemetic guidelines

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Abstract

As many as 40–80% of patients undergoing radiotherapy (RT) will experience nausea and/or vomiting, depending on the site of irradiation. Fractionated RT may involve up to 40 fractions over a 6–8 weeks period, and prolonged symptoms of nausea and vomiting could affect quality of life. Furthermore, uncontrolled nausea and vomiting may result in patients delaying or refusing further radiotherapy. Nausea and vomiting are often underestimated by radiation oncologists. Incidence and severity of nausea and vomiting depend on RT-related factors (single and total dose, fractionation, irradiated volume, radiotherapy techniques) and patient-related factors (gender, general health of the patient, age, concurrent or recent chemotherapy, psychological state, tumor stage). Current antiemetic guidelines prescribe the emetogenicity of radiotherapy regimens and recommend the use of 5-HT3 antagonists with or without a steroid for prophylaxis in moderately and highly emetogenic treatment (MASCC, ASCO, ASHP, NCCN). The new proposed guidelines summarise the updated data from the literature and take into consideration the existing guidelines. According to the irradiated area (the most frequently studied risk factor), the proposed guidelines are divided into four levels of emetogenic risk: high, moderate, low and minimal. They offer guidance to prescribing physicians for effective antiemetic therapies in RINV.

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Authors and Affiliations

  1. Department of Radiotherapy, Nuclear Medicine, Vivantes Medical Center Berlin-Neukölln, Rudower Str. 48, 12351, Berlin, Germany

    Petra Ch. Feyer

  2. U.O. de Radioterapia Oncologica, Azienda Ospedaliera “S.S. Maria”, Via T. di Joannuccio 1, 05100, Terni, Italy

    Ernesto Maranzano

  3. School of Nursing, Midwifery and Health Visiting, University of Manchester, Coupland III Building, Manchester, M13 9PL, UK

    Alexander Molassiotis

  4. The University of Kansas Cancer Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160–7820, USA

    Rebecca A. Clark-Snow

  5. Medical Oncology Division, Policlinico Hospital, 06122, Perugia, Italy

    Fausto Roila

  6. Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, Canada

    David Warr

  7. University of Adelaide, Royal Adelaide Hospital Cancer Centre, North Terrace, 5000, Adelaide, South Australia, Australia

    Ian Olver

Authors
  1. Petra Ch. Feyer
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  2. Ernesto Maranzano
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  3. Alexander Molassiotis
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  4. Rebecca A. Clark-Snow
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  5. Fausto Roila
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  6. David Warr
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  7. Ian Olver
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Corresponding author

Correspondence to Petra Ch. Feyer.

Additional information

Perugia Antiemetic Consensus Conference 2004.

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Feyer, P.C., Maranzano, E., Molassiotis, A. et al. Radiotherapy-induced nausea and vomiting (RINV): antiemetic guidelines. Support Care Cancer 13, 122–128 (2005). https://doi.org/10.1007/s00520-004-0705-3

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  • DOI: https://doi.org/10.1007/s00520-004-0705-3

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