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Evolution of antiemetic studies for radiation-induced nausea and vomiting within an outpatient palliative radiotherapy clinic

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Abstract

Purpose

Radiation-induced nausea and vomiting (RINV) is a common side effect of radiotherapy and can affect up to 50–80% of patients, potentially causing detrimental effects to physical health, clinical efficacy, and patient quality of life. Antiemetic drugs act on receptors involved in the emesis pathway to block the uptake of neurotransmitters and inhibit stimulation of vomiting centers in the brain to prevent and treat RINV. The most commonly prescribed antiemetics for RINV are 5-hydroxytryptamine receptor antagonists (5-HT3 RA). Guidelines describing the optimal management of RINV are produced by the Multinational Association for Supportive Care in Cancer, the European Society of Medical Oncology, the American Society of Clinical Oncology, and the National Comprehensive Cancer Network. This review will present findings from research on antiemetic management for RINV conducted at our center.

Methods

A selective review of research conducted in a palliative outpatient radiotherapy clinic relating to antiemetic management for RINV was performed.

Results

Several studies investigating the efficacy of different routes of administration, new antiemetic drug types, and novel combinations of antiemetics have been tested at our clinic to elucidate which approach provides the best response. These include studies on the use of ondansetron rapidly dissolving film, palonosetron, and the addition of a neurokinin-1 receptor antagonist to traditional 5-HT3 RA regimens.

Conclusions

These studies provide a framework for future research and could potentially inform changes to future guidelines to include the use of these novel regimens and techniques.

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Funding

We thank the generous support of the Bratty Family Fund, Michael and Karyn Goldstein Cancer Research Fund, Joey and Mary Furfari Cancer Research Fund, Pulenzas Cancer Research Fund, Joseph and Silvana Melara Cancer Research Fund, and Ofelia Cancer Research Fund.

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Authors and Affiliations

  1. Rapid Response Radiotherapy Program, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada

    Erin McKenzie, Dominic Chan, Shima Parsafar, Yasmeen Razvi, Victoria Rico & Edward Chow

  2. Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada

    Thomas McFarlane, Mark Pasetka & Carlo DeAngelis

  3. Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada

    Edward Chow

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  1. Erin McKenzie
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  2. Dominic Chan
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Correspondence to Edward Chow.

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McKenzie, E., Chan, D., Parsafar, S. et al. Evolution of antiemetic studies for radiation-induced nausea and vomiting within an outpatient palliative radiotherapy clinic. Support Care Cancer 27, 3245–3252 (2019). https://doi.org/10.1007/s00520-019-04870-6

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  • DOI: https://doi.org/10.1007/s00520-019-04870-6

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