Guidelines for Complications of Cancer Treatment Vol VIII Part B

and follow-up after treatment for nausea and vomitingsymptoms. In addition, patients with cancer and small bowelobstruction were examined as a special subset of patients whopresent with nausea and vomiting. The standards presentedhere for preventing and managing nausea and vomiting incancer care should be incorporated into care pathways andshould become the expectation rather than the exception.2. American Society of Clinical OncologyGuideline for Antiemetics in Oncology: Update2006Mark G.K, Paul J.H, Mark R.S, et al. J Clin Oncol2006; 24:2932-47.PURPOSE: To update the 1999 American Society of ClinicalOncology guideline for antiemetics in oncology.UPDATEMETHODOLOGY: The Update Committee completed areview and analysis of data published from 1998 thru February2006. The literature review focused on published randomizedcontrolled trials, and systematic reviews and meta-analyses ofpublished phase II and phase III randomized controlled trials.RECOMMENDATIONS: The three-drug combination of a5-hydroxytryptamine-3 (5-HT 3) serotonin receptor antagonist,dexamethasone, and aprepitant is recommended beforechemotherapy of high emetic risk. For persons receivingchemotherapy of high emetic risk, there is no group of patientsfor whom agents of lower therapeutic index are appropriatefirst-choice antiemetics. These agents should be reserved forpatients intolerant of or refractory to 5-HT 3serotonin receptorantagonists, neurokinin-1 receptor antagonists, anddexamethasone. The three-drug combination of a 5-HT 3receptor serotonin antagonist, dexamethasone, and aprepitantis recommended for patients receiving an anthracycline andcyclophosphamide. For patients receiving other chemotherapyof moderate emetic risk, the Update Committee continues torecommend the two-drug combination of a 5-HT 3receptor401