Controlling the toxicity of palliative radiotherapy: the role of 5-HT3 antagonists

A significant number of cancer patients undergoing palliative radiotherapy experience treatment-related nausea and vomiting. A number of factors are known to influence the incidence and severity of radiation-induced sickness including the site, field size and dose per fraction. The age of the patient and the level of patient anxiety may also play a role. Furthermore, there is some evidence that high alcohol consumption has a protective effect against radiation-induced illness. It is generally accepted that there is a high risk of nausea and vomiting associated with high doses of radiotherapy; however, this effect has never been adequately quantified. Nonetheless, as a consequence of radiation-induced nausea and vomiting, patients may experience a decrease in their quality of life and may choose to delay or even refuse further treatment. Thus, controlling the adverse side effects associated with radiation therapy is critical to optimal patient care.