Latin-american guidelines for the management of emesis in oncology, haemato-oncology, and radiotherapy. Guías latinoamericanas para el manejo de la emesis en oncología, hematooncología y radioterapia.

Abstract

The treatment for the oncological patient is complex because the pathology in itself requires a systemic management. The different therapies –which search for restoring the health of the patients, or at least improving their quality of life– constantly must be modified because their adverse effects usually make the patients to interrupt the treatment or abandon it altogether. Such is the case of nausea and vomiting induced by radiotherapy and chemotherapy, which cause troublesome ailments to the patients and that have been treated with more effective antiemetics for over two decades. Long time ago, several international oncological institutions have published guidelines to homogenize the management criteria of the nausea and vomiting induced by chemotherapy. Nevertheless, there has been a lack of specific and adaptive guidelines for LatinAmerica, region where there are particular circumstances related to drugs availability and access to resources. Taking all this into account, a group of oncologists, haematologists, and paediatric oncologists from Latin-America gathered with the purpose of agreeing about the general management and specific recommendations of the antiemetic drugs administration alone or in combination; as well as to establish the management of emesis guidelines according to the Latin-American context. The experts answered a Delphi questionnaire which contained the basic concepts of the antiemetic treatment. They graded them with the criteria agree and disagree. Later on, they assembled again to discuss the controversial concepts, reviewed the most outstanding literature reports (including the MASCC, NCCN, and ASCO guidelines), and finally, they draw up the Latin-American guides for the control of emesis.