Chemotherapy induced nausea and vomiting--prevention and treatment.
ABSTRACT Chemotherapy induced nausea and vomiting are among the most feared consequences of cancer treatment. Recent developments in drug treatment make the goal of no nausea or vomiting during chemotherapy realistic.
In this article we review the pathogenesis and management of chemotherapy induced nausea and vomiting.
Regimens to prevent chemotherapy induced nausea and vomiting are guided by the emetogenic potential of the chemotherapeutic agents used. Combined prophylactic therapy targets different pathways, improving the efficacy of prevention and treatment of chemotherapy induced nausea and vomiting. General practitioners have an important role in patients undergoing chemotherapy by reinforcing the importance of prophylactic treatment and administering rescue treatment for patients with breakthrough or prolonged nausea and vomiting postchemotherapy.
- SourceAvailable from: etd.lib.umt.edu
- "Since that time, it has been shown that serotonin has important roles in multiple biological systems as a neurotransmitter and a paracrine autacoid factor. Serotonergic dysfunction has been implicated in multiple disease states for which treatments have been developed including depression, obsessivecompulsive disorder, migraine headache, and emesis (Cowen, 2000; Pietrobon, 2003; Mann, 2005; Feeney et al., 2007). Reserpine and ergot alkaloids were two of the first agents, which were used clinically. "
- [Show abstract] [Hide abstract]
ABSTRACT: In recent years, geriatricians and oncologists have worked together to evaluate elderly patients with cancer before and during treatment, to estimate the balance between the efficacy and safety of chemotherapy and to upgrade treatment in this population according to their comorbidity and physiological status. The clinical and biological factors of this population need to be assessed in multidisciplinary comprehensive geriatric assessment (CGA) in order to optimize treatment without inducing major adverse effects. We reviewed the nutritional aspects of this evaluation that highlight the impact of undernutrition on poor survival. In this paper we briefly describe tumoral cachexia (molecular and physiological), the impact of undernutrition on cancer prognosis (predictive factors), therapeutic effects of cancer on nutritional status, nutritional indicators (biological, anthropometric) and undernutrition in the elderly (specific needs of this population). The potential for nutritional intervention in geriatric oncology with regard to CGA is explored.Critical Reviews in Oncology/Hematology 07/2008; 67(3):243-54. DOI:10.1016/j.critrevonc.2008.04.005 · 4.03 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Gene directed enzyme prodrug therapy (GDEPT) of cancer aims to improve the selectivity of chemotherapy by gene transfer, thus enabling target cells to convert nontoxic prodrugs to cytotoxic drugs. A zone of cell kill around gene-modified cells due to transfer of toxic metabolites, known as the bystander effect, leads to tumour regression. Here we discuss the implications of either striving for a strong bystander effect to overcome poor gene transfer, or avoiding the bystander effect to reduce potential systemic effects, with the aid of three successful GDEPT systems. This review concentrates on bystander effects and drug development with regard to these enzyme prodrug combinations, namely herpes simplex virus thymidine kinase (HSV-TK) with ganciclovir (GCV), cytosine deaminase (CD) from bacteria or yeast with 5-fluorocytodine (5-FC), and bacterial nitroreductase (NfsB) with 5-(azaridin-1-yl)-2,4-dinitrobenzamide (CB1954), and their respective derivatives.Molecules 11/2009; 14(11):4517-45. DOI:10.3390/molecules14114517 · 2.42 Impact Factor