STANDARD TREATMENT OF CHEMOTHERAPY-INDUCED EMESIS

Major breakthroughs in the treatment of chemotherapy-induced emesis ha ve come through the use of selective 5-HT3 receptor antagonists in com bination with corticosteroids. This combination can be considered stan dard for most but not all commonly used chemotherapeutic agents. Delay ed onset emesis remains a problem, particularly for patients receiving high-dose cisplatin, There is debate over the value of using selectiv e 5-HT3 receptor antagonists beyond the first 24 h. Clinical trials ha ve not settled this uncertainty, although it seems likely that they ad d only modestly to the effect of corticosteroids. For both the acute a nd delayed phases, dopamine receptor antagonists may add to the effect iveness of antiemetic therapy. This article outlines a strategy for in itial antiemetic therapy and the rationale For the recommendations.