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中华结直肠疾病电子杂志 ›› 2024, Vol. 13 ›› Issue (05) : 353 -361. doi: 10.3877/cma.j.issn.2095-3224.2024.05.001

指南与共识

直肠癌新辅助治疗相关恶心、呕吐副反应的预防、诊断及治疗指南
中国抗癌协会结直肠肿瘤整合康复专业委员会, 北京癌症防治学会直肠癌新辅助治疗专业委员会   
  • 收稿日期:2024-08-12 出版日期:2024-10-25
  • 基金资助:
    中央高水平医院临床科研专项(No. 2022-PUMCH-C-005)

Guidelines on prevention,diagnosis,and treatment of nausea and vomiting caused by neoadjuvant therapies for rectal cancer

Anti-cancer Association Colorectal Tumor Integrated Rehabilitation Committee, Neoadjuvant Therapy for Rectal Cancer Professional Committee of Beijing Cancer Prevention & Treatment Society Chinese   

  • Received:2024-08-12 Published:2024-10-25
引用本文:

中国抗癌协会结直肠肿瘤整合康复专业委员会, 北京癌症防治学会直肠癌新辅助治疗专业委员会. 直肠癌新辅助治疗相关恶心、呕吐副反应的预防、诊断及治疗指南[J]. 中华结直肠疾病电子杂志, 2024, 13(05): 353-361.

Anti-cancer Association Colorectal Tumor Integrated Rehabilitation Committee, Neoadjuvant Therapy for Rectal Cancer Professional Committee of Beijing Cancer Prevention & Treatment Society Chinese. Guidelines on prevention,diagnosis,and treatment of nausea and vomiting caused by neoadjuvant therapies for rectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(05): 353-361.

新辅助治疗是局部进展期中低位直肠癌的标准治疗。近年来,全程新辅助治疗(TNT)、新辅助免疫治疗等治疗模式的探索使新辅助治疗的疗效不断提高,但治疗相关的恶心、呕吐仍然常见,不仅会影响患者的生活质量,还会降低治疗依从性,尤其在全程新辅助治疗等长疗程治疗时,可能导致治疗延迟或中断,严重影响治疗效果。目前,针对直肠癌新辅助治疗相关的恶心、呕吐副反应的预防、诊断及治疗尚缺乏专业规范的临床指南和专家共识。为此,中国抗癌协会结直肠肿瘤整合康复专业委员会和北京癌症防治学会直肠癌新辅助治疗专业委员会组织专家,整合近年来相关研究进展,遵循国内外循证医学证据,参考现有抗肿瘤治疗相关恶心、呕吐治疗指南及专家共识,结合临床实践,经反复研讨,共同制定了直肠癌新辅助治疗相关恶心、呕吐副反应的预防、诊断及治疗指南,该指南旨在为接受直肠癌新辅助治疗出现恶心、呕吐相关副反应的患者提供预防诊断和治疗等方面的专业指导和建议,以期提高新辅助治疗效果,从而改善患者的生活质量和治疗预后。

Neoadjuvant radiochemotherapy is the standard treatment for locally advanced rectal cancer. In recent years,the exploration of treatment modalities such as total neoadjuvant therapy(TNT)and neoadjuvant immunotherapy has led to the continuous improvement of the efficacy of neoadjuvant therapy,but treatment-related nausea and vomiting are still common,which not only affects the quality of life,but also reduces the adherence to the treatment,especially in the case of a long course of treatment such as the total neoadjuvant therapy,which may lead to delayed or interrupted treatment and seriously affects the effectiveness of the treatment. At present,there is a lack of specialized guidelines for the prevention,diagnosis,and treatment of nausea and vomiting associated with neoadjuvant therapy for rectal cancer. For this reason,the Chinese Anti-cancer Association Colorectal Tumor Integrated Rehabilitation Committee and Beijing Cancer Prevention & Treatment Society have organized experts to consolidate the relevant research progress in recent years,follow the evidence of domestic and international evidence-based medical science,refer to the existing guidelines and experts' consensus,and combine with the clinical practice. The guideline aims to provide professional guidance and suggestions for the prevention and treatment of nausea and vomiting side effects associated with neoadjuvant therapy for rectal cancer,to improve the prognosis and quality of life of patients and therapeutic effect.

表1 指南证据级别与推荐强度
表2 化疗相关恶心、呕吐副反应分类
表3 常见直肠癌新辅助放化疗方案与出现恶心、呕吐副反应预防性用药方案
表4 常用止吐药物种类及使用方案
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