[Nausea and vomiting in cancer patients]

Despite an increasing number of antiemetic drugs available, nausea and vomiting (NV) remain a central problem during chemotherapy. Acute and delayed NV benefit most often from the combination of classical antiemetic (such as metoclopramide or metopimazin), corticosteroids and 5HT3 inhibitors (setrons). Since 2006, a new class of antiemetics are available, the NK1 inhibitors (aprepitant), which improve the control of NV in combination with setrons and corticosteroids. Anticipatory NV must be treated with benzodiazepines. Other causes of NV must be discussed in those patients, such as gastro intestinal or metabolic disorders, cancer evolution such as occlusion, brain metastases. A global approach is necessary to improve the quality of life all along the courses of chemotherapy, including somatic and psychologic aspects.