Management of other non-cisplatin-induced emesis

A number of non-cisplatin cytotoxic regimens induce moderate to severe nausea and emesis. Moreover, the majority of these regimens are given to outpatients where an effective, well-tolerated anti-emetic therapy is particularly important to maintain patients' well-being. This review focuses on the management of nausea and emesis induced by non-cisplatin chemotherapy particularly regimens that do not contain cyclophosphamide or carboplatin, as these are reviewed elsewhere in this volume. For patients receiving highly emetogenic cytotoxic therapy such as dacarbazine, total body irradiation or hemi-body irradiation, a 5-HT3 receptor antagonist plus a corticosteroid may provide optimal control of emesis and nausea. High-dose single-fraction and fractionated radiotherapy to the upper abdomen induces moderate emesis. Traditional anti-emetics prevent emesis in approximately 50% of patients; 5-HT3 receptor antagonists provide a more effective anti-emetic therapy for these patients. Studies evaluating anti-emetics in specific chemotherapy regimens will give clear guidelines for the management of emesis in different patient populations.