[Risk management in ambulatory anti-cancer therapy, focusing on nausea and vomiting]

Patients who receive ambulatory-based chemotherapy worry about nausea and vomiting leading to appetite loss, decreased activity, and finally, the lowering of QOL. The management of nausea and vomiting also prevents decreased body weight loss, encourages compliance with chemotherapy treatments, and promotes social activity. Recently, NCCN, ASCO, MASCC as well as JSCO guideline for antiemesis were updated and approved for delayed antiemetic drugs in Japan. According to these guidelines, we should administer antiemetic drugs appropriately to prevent anticipatory emesis. Last year, in a retrospective analysis of head and neck cancer, in a comparison of before and after the use of aprepitant, the use can improved the dose intensity of CDDP and one-year survival after chemotherapy. We need to have prospective analyses, but appropriate use of antiemetic drugs and management of chemotherapy lead to a better clinical outcome and safety.