ABSTRACT
No disponible
Subject(s)
Humans , Neoplasms/epidemiology , Internet , Consumer Health Information/trends , Access to InformationABSTRACT
Nausea and vomiting are considered one of the most distressing side-effects of chemotherapy. Complete control of acute and delayed emesis improves quality of life and increases adherence to treatment. The frequency of nausea and vomiting depends primarily on the emetogenic potential of the chemotherapeutic agents used. With the standard antiemetic therapy (5HT-3 receptor antagonists in combination with dexamethasone) approximately 13% of patients receiving chemotherapy have vomiting in the acute phase and almost 50% in the delayed phase. A new group of antiemetic drugs, the neurokinin-1 receptor antagonists, in combination with standard therapy significantly improves emesis protection in the acute and in the delayed phase, although control of nausea is not so effective. Nowadays chemotherapy-induced emesis still occurs. Recent developments in antiemetic therapy and responsibility to achieve the best control of nausea and vomiting in patients receiving chemotherapy justified a review of this problem, which is frequently underestimated by physicians and nurses.
Subject(s)
Antiemetics/therapeutic use , Antineoplastic Agents/adverse effects , Nausea/chemically induced , Nausea/prevention & control , Vomiting/chemically induced , Vomiting/prevention & control , HumansABSTRACT
Las náuseas y los vómitos continúan siendo uno de los efectos adversos más temidos por los pacientes en tratamiento con quimioterapia. Un control adecuado de la emesis inducida por la quimioterapia mejora la calidad de vida. La frecuencia de náuseas y vómitos depende principalmente del agente quimioterapéutico empleado. Con el tratamiento antiemético actual (antagonistas de la serotonina y dexametasona) aproximadamente el 13% de los pacientes presenta vómitos en la fase aguda y casi un 50%, en la tardía. Los antagonistas del receptor de la neurocinina-1, asociados al tratamiento antiemético estándar, mejoran significativamente el control de la emesis aguda y de la emesis tardía, aunque no son tan eficaces en la prevención de las náuseas. Actualmente, se debería conseguir el control completo de las náuseas y los vómitos en los pacientes con cáncer en tratamiento quimioterapéutico
Nausea and vomiting are considered one of the most distressing side-effects of chemotherapy. Complete control of acute and delayed emesis improves quality of life and increases adherence to treatment. The frequency of nausea and vomiting depends primarily on the emetogenic potential of the chemotherapeutic agents used. With the standard antiemetic therapy (5HT-3 receptor antagonists in combination with dexamethasone) approximately 13% of patients receiving chemotherapy have vomiting in the acute phase and almost 50% in the delayed phase. A new group of antiemetic drugs, the neurokinin-1 receptor antagonists, in combination with standard therapy significantly improves emesis protection in the acute and in the delayed phase, although control of nausea is not so effective. Nowadays chemotherapy-induced emesis still occurs. Recent developments in antiemetic therapy and responsibility to achieve the best control of nausea and vomiting in patients receiving chemotherapy justified a review of this problem, which is frequently underestimated by physicians and nurses
Subject(s)
Humans , Antineoplastic Agents/adverse effects , Antiemetics/therapeutic use , Vomiting/drug therapy , Nausea/drug therapy , Quality of Life , Risk Factors , Benzodiazepines/therapeutic use , Cannabinoids/therapeutic use , Glucocorticoids/therapeutic use , Neoplasms/drug therapyABSTRACT
Current issues of adjuvant therapy for colon cancer concern the introduction of drugs other than fluorouracil-5/leucovorin (5-FU/LV), the benefits for stage II patients, the use of new primary endpoints and the influence of age on treatment benefits. These issues were addressed in a panel discussion and the conclusions were the following: FOLFOX4 is the first regimen that shows superiority over 5-FU/LV. The use of 3-year disease-free survival as primary endpoint could encourage the quicker adoption of improved therapeutic strategies into clinical practice. Available data suggest that there are some benefits for stage II patients, and the decision needs to be individualised for each patient. Further, therapeutic decisions based solely on the patient's age are inappropriate, and geriatric assessment tools will help in making this decision. This information would improve patient and physician understanding of the recent data regarding the potential benefits of adjuvant therapy.
Subject(s)
Colonic Neoplasms/therapy , Age Factors , Aged , Chemotherapy, Adjuvant , Clinical Trials as Topic , Disease-Free Survival , HumansABSTRACT
Las controversias actuales referentes al tratamiento adyuvante del cáncer de colon incluyen la introducción de fármacos más allá de 5-FU/LV, el beneficio que ofrece a los pacientes con estadio II, el uso de nuevas variables y la influencia de la edad sobre los beneficios del tratamiento. Estas controversias fueron discutidas en un panel de expertos y las conclusiones fueron las siguientes: FOLFOX4 es el primer régimen que ha demostrado superioridad frente a 5-FU/LV. El uso de la supervivencia libre de enfermedad a 3 años como variable principal de los estudios podrá permitir una adopción más rápida de estrategias terapéuticas. Los datos disponibles sugieren que existe beneficio para los pacientes con estadio II, y la decisión terapéutica debe ser individualizada. Finalmente, también se llegó a la conclusión de que las decisiones basadas únicamente en la edad no son apropiadas, y las herramientas de valoración geriátrica servirán de apoyo. Esta información puede mejorar el entendimiento de pacientes y médicos acerca de los datos recientes relativos a los beneficios del tratamiento adyuvante
Current issues of adjuvant therapy for colon cancer concern the introduction of drugs other than fluorouracil-5/leucovorin (5-FU/LV), the benefits for stage II patients, the use of new primary endpoints and the influence of age on treatment benefits. These issues were addressed in a panel discussion and the conclusions were the following: FOLFOX4 is the first regimen that shows superiority over 5-FU/LV. The use of 3-year disease-free survival as primary endpoint could encourage the quicker adoption of improved therapeutic strategies into clinical practice. Available data suggest that there are some benefits for stage II patients, and the decision needs to be individualised for each patient. Further, therapeutic decisions based solely on the patient's age are inappropriate, and geriatric assessment tools will help in making this decision. This information would improve patient and physician understanding of the recent data regarding the potential benefits of adjuvant therapy
