Çocuklarda kemoterapiye bağlı bulantı ve kusma için kullanılan antiemetik tedavinin değerlendirilmesi

Suna Emir

Derleme

Evaluation of antiemetic therapy used for chemotherapy induced nausea and vomiting in children

Yıl 2017, Cilt: 15 Sayı: 3, 49 - 57, 01.12.2017

Suna Emir

Öz

Kemoterapiyle
ilişkili bulantı ve kusma, kanserli çocuklarda tedavinin önemli yan
etkilerinden birisidir. Yeni
antiemetik ajanlar gelişmiş olmasına ragmen çocukluk yaş grubunda halen bazı sorunlar vardır.
Çocuklarda kemoterapiye bağlı bulantı ve kusmayı önlemek için genellikle
bir 5-HT3 reseptor antagonisti ile kortikosteroid birlikte kullanımı önerilir. Yeni antiemetik ilaçlar
güncel pediatri kılavuzlarında yer almazlar. Dirençli kusması olan çocuklarda
alternatif ajanların kullanımına ilişkin yeterli veri yoktur. Bu derlemede; çocuklarda kemoterapiye bağlı
bulantı kusma ile ilgili tanımlar, çocuklarda kullanılan antiemetik ilaçların
standart ilaçlar, isteğe bağlı ilaçlar ve yeni ilaçlar olarak sınıflandırılması
özetlenmiştir. Her ilaç kategorisi, etki
mekanizması, dozları ve çocuklarda antiemetik tedaviyle ilgili bazı öneriler
tartışılmıştır.

Abstract

Nausea
and vomiting associated with chemotherapy is one of the important side
effects of treatment in children with cancer. Despite the development of new antiemetic
agents, there are still some problems in this regard in children. The combination of a 5-HT3 receptor antagonist plus a corticosteroid
is usually used to prevent chemotherapy induced nausea and vomiting (CINV) in children receiving emetogenic
chemotherapy. New antiemetic agents do
not take part in the current pediatric guidelines. There
is also no sufficient data on alternative
agents in children with intractable vomiting.
This review summarizes the CINV definitions in children, the
classification of the antiemetic drugs as standard, newly available and
optional drugs in children.

Each
drug category is discussed according to the mode of action, efficacy in
different types of CINV, recommended dose and finally some suggestions for CINV in children.

Anahtar Kelimeler

Nausea, vomiting, chemotherapy, children, Bulantı, kusma, kemoterapi, çocuklar

Kaynakça

1. Dewan P, Singhal S, Harit D. Management of Chemotherapy-induced nausea and vomiting. Indian Pediatrics 2010; 47:149-55.
2. Dupuis L, Nathan PC. Optimizing emetic control in children receiving antineoplastic therapy. Pediatr Drugs 2010; 12:51-61.
3. Jordan K, Roila F, Molassiotis A, Maranzo E, Clark-Snow-RA, Feyer P. Antiemetics in children receiving chemotherapy. MASCC/ESMO guidelines update 2009. Support Care Cancer 2011; 37-42.
4. Philips RS, Gopaul S, Gibson F, Houghton E, Craig JV, Light K, et al. Antiemetic medication for prevention and treatment of chemotherapy induced nausea and vomiting in childhood. Cochrane Database Syst. Rev. 2010; 9:Cd 007786.
5. Dupuis LL, Boodhan S, Holdsworth M, Robinson PD, Hain R, Portwine C, O’ Shaughnessy E, Sung L. Guideline for the prevention of Acute Nausea and vomiting due to Antineoplastic medication in pediatric patients Pediatr Blood Cancer 2013; 60:1073-82.
6. Cefalo MG, Ruggiero A, Maurizi P, Attina G, Arlotta A, Riccardi R. Pharmacological Management of Chemotherapy induced Nausea and vomitingin children with cancer. J Chemother 2009; 21:605-10.
7. Dupuis LL, Robinson PD, Boodhan S, Holdsworth M, Portwine C, Gibson P, Philips R, Maan C, Stefin N, Sung L Guideline for the prevention and treatment of Anticipatory Nausea and vomiting due to chemotherapy in pediatric patients. Pediatr Blood Cancer 2014; 61:1506-12.
8. Lohr R. Chemotherapy- induced nausea and vomiting. Cancer J 2008; 14:85-93.
9. Hesketh PJ, Kris MG, Grunberg SM, et al. A proposal for classifying the acute emetogenicity of cancer chemotherapy. J Clin Oncol 1997; 15:103-9.
10. Berrak SG, Özdemir N, Bakırcı N, Türkkan E, Canpolat C, Beker B, et al. A double-blind, crossover, randomized dose-comparison trial of granisetron for the prevention of acute and delayed nausea and emesis in children receiving moderately emetogenic carboplatin-based chemotherapy. Support Care Cancer 2007; 15: 1163-8.
11. Schmoll HJ, Aapro MS, Poli-Bigelli S,Kim HK, Park K, Jordan K, et al. Comparison of an aprepitant regimen with a multiple –day ondansetron regimen, both with dexamethasone, for antiemetic efficacy in high dose cisplatin treatment. Ann Oncol 2006; 17:1000-6.
12. Jordan K, Schmoll HJ, Aapro MS. Comparative activity of antiemetic drugs. Critical reviews in oncology/hematology 2007; 61: 162-75.
13. Büyükavcı M, Olgun H, Ceviz N. The effects of ondansetron and granisetron on electrocardiography in children receiving chemotherapy for acute leukemia Am J Clin Oncol 2005; 28:201-4.
14. Grunberg SM. Antiemetic activity of corticosteroids in patients receiving cancer chemotherapy: dosing, efficacy, and tolerability analysis. Ann oncol 2007; 18:233-40.
15. Gore L, Chawla S, Petrilli A, Hemenway M, Schissel D, Chua V, et al. Aprepitant in Adolescent patients for prevention of chemotherapy induced nausea and vomiting: A randomized, double-blind, placebo-controlled study of efficacy and tolerability. Pediatr Blood Cancer 2009; 52:242-7.
16. Kang HJ, Loftus S, Taylor A, Di Cristina C, Green S, Zwaan CM. Aprepitant for the prevention of chemotherapy-induced nausea and vomiting in children: a randomized, double-blind, phase 3 trial. Lancet Oncol 2015;16 (4):385-94.
17. Mandala M, Cremonesi M, Rocca A, Cazzaniga M, Ferreti G, Di Cosimo S, et al. Midazolam for acute emesis refractory to dexamethasone and granisetron after highly emetogenic chemotherapy: a phase II study. Support Care Cancer 2005; 13:375-80.
18. Dix SP, Cord MK, Howard SJ, Coon JL, Belt RJ, Geller RB. Safety and efficacy of a continuous infusion, patient controlled antiemetic pump to facilitate outpatient administration of high-dose chemotherapy. Bone Marrow transplant 1999; 24:561-6.
19. Emir S, Erturgut P, Vidinlisan S. Comparison of granisetron plus dexamethasone versus an antiemetic cocktail containing midazolam and diphenhydramine for chemotherapy induced nausea and vomiting in children . Indian J Med Pediatr Oncol 2013; 34(3): 270-3.
20. Flank J, Thackray J, Nielson D, August A, Schechter T, Alexander S, Sung L, Dupuis LL. Olanzapine for treatment and prevention of acute chemotherapy induced vomiting in children: A retrospective, Multi-center Review. Pediatr Blood Cancer 2015; 62:496-501.