Radiotherapy-induced nausea and vomiting: Prophylaxis and treatment
- Petra Feyer, MD
Petra Feyer, MD
- Head of Department, Radiation Oncology
- Vivantes Clinics Berlin Neukoelln
- Karin Jordan, MD
Karin Jordan, MD
- Associate Professor
- Universitätsklinikum Heidelberg
- Section Editors
- Paul J Hesketh, MD
Paul J Hesketh, MD
- Section Editor — Supportive Care
- Chair, Lahey Health Cancer Institute
- Director, Thoracic Oncology, Lahey Hospital and Medical Center
- Professor of Medicine, Tufts University School of Medicine
- Steven E Schild, MD
Steven E Schild, MD
- Section Editor — Radiation Therapy
- Professor of Radiation Oncology
- Mayo Clinic College of Medicine
Nausea and vomiting caused by radiotherapy (RT) are generally less severe than that caused by chemotherapy, but nausea and vomiting can last for a prolonged period in some cases. These side effects are clinically important and can be distressing for patients. Furthermore, RT-induced nausea and vomiting (RINV) can cause patients to delay or refuse further treatment.
The incidence, classification of risk, and management of RINV are discussed here. The approach to chemotherapy-induced nausea and vomiting is discussed separately. (See "Prevention and treatment of chemotherapy-induced nausea and vomiting in adults".)
The pathophysiology of radiotherapy (RT)-induced nausea and vomiting (RINV) is incompletely understood but is thought to be similar to that caused by chemotherapy. Progress in understanding the pathophysiology of chemotherapy-induced emesis led to the development of agents that form the basis for treatment of RINV. (See "Pathophysiology and prediction of chemotherapy-induced nausea and vomiting".)
Two prospective observational studies provide information on the frequency of radiotherapy (RT)-induced nausea and vomiting (RINV) and the extent to which this problem is treated:
●The Italian Group for Antiemetic Research in Radiotherapy (IGARR) analyzed the incidence of RINV in 1020 patients receiving various kinds of RT with or without concomitant chemotherapy . Overall, nausea and/or vomiting was reported by 28 percent. The median time to the first episode of vomiting was three days. Antiemetic drugs were administered to 17 percent of the patients, including 12 percent treated prophylactically and 5 percent given rescue therapy.
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