Guidelines for Use of Antiemetics


Introduction

  • Nausea and vomiting are common during and after radiation therapy of certain areas (e.g., whole brain, whole body, hemi-body, cranio-spinal, upper abdomen), as well as during certain anti-cancer chemotherapies.
  • Prevention and treatment of nausea and vomiting in these clinical oncology settings has a long history. Many clinical practice guidelines have been published on antiemetics, with periodic updates as new drugs are introduced.
  • Nausea and vomiting are also key signs of exposure to whole-body or significant partial-body radiation during radiation accidents. Time-to-vomiting appears to correlate with whole body dose.
  • During a mass casualty radiation emergency, diagnosis and treatment of radiation-induced nausea and vomiting in the general public will always be after the incident has occurred and after medical responders have accessed patients. At least initially, there may not be adequate resources to treat all who may need anti-emetic treatment.
  • Clinical antiemetic guidance on REMM focuses on mass casualty radiation emergencies. In the absence of formal, prospective research on optimal guidelines for antiemetic clinical treatment during large radiation emergencies, antiemetic information on REMM derives from experience in oncology practice and expert opinion. Links on this page serve as background information only. No uniformly accepted clinical guidance exists for optimal use of anti-emetics during large mass casualty radiation emergencies.
  • The links on this page represent peer-reviewed content about nausea and vomiting in the oncology setting for children and adults.
  • See REMM’s antiemetics section in the Template for Hospital Orders in adults and children for guidance on post radiation antiemetic therapies considered by REMM and RITN experts.
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Basic Science and Drug Delivery


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Comparison of Clinical Guidelines from Major Clinical Trials Groups

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Multinational Association for Supportive Care in Cancer / European Society for Medical Oncology (MASCC/ESMO)

MASCC/ESMO Antiemetic Guidelines (Requires registration)

About the MASCC/ESMO Antiemetic Guidelines Update

MASCC/ESMO guidance from peer-reviewed journals top of page

National Comprehensive Cancer Network NCCN®

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American Society for Clinical Oncology (ASCO)

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Children