부인암 항암화학요법에 대한 예방적 항구토제 처치법
PROPHYLACTIC ANTIEMETICS THERAPY AGAINST GYNECOLOGIC CANCER CHEMOTHERAPY
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초록
부인암환자에서 항암제에 의한 오심 및 구토(chemotherapy induced nausea and vomiting, CINV)는 대부분에서 나타난다. 항암제에 의한구토의 위험요소를 평가하는 일은 치료에 있어서도 중요하다 할 수 있다. American Society of Clinical Oncology, Multinational Association for Supportive Care in Cancer와 National Comprehensive Cancer Network 등에서 근거중심의학에 비추어 예방목적의 항구토제 지침을발표하였다. Serotonin receptor antagonist, dexamethasone 등의 약제에 필요에 따라 NK1 antagonist를 추가하는 것이 항암치료를 받는환자에 있어 가장 권장할 만한 예방법이다. 최근 들어 palonosetron, transdermal granisetron 등의 제제가 소개되어 항암치료 중 나타나는오심, 구토에 사용이 되고 있다. 오심 및 구토에 대한 병태생리학적 이해를 높이는 것이 부인암 환자의 항암치료에 따른 예방적 항구토제의 사용에 중요하다 할 수 있다.
Abstract
Nausea and vomiting associated with gynecologic cancer chemotherapy are experienced by most of patients receiving chemotherapy. Assessment of vomiting risk by chemotherapy and risk factor are mandatory for rescue of chemotherapy induced nausea and vomiting (CINV). Piled-up evidence based medicine result in prophylactic antiemetics guideline from American Society of Clinical Oncology,Multinational Association for Supportive Care in Cancer, and National Comprehensive Cancer Network. Combination of serotonin receptor antagonist, dexamethason, and with/without NK1 antagonist is the best prophylaxis in patients receiving highly and moderate emetogenic chemotherapy. Other new regimens (palonosetron, transdermal granisetron) are introduced to relieve the active symptom of delayed CINV. Comprehensive understading of pathophysiology of CINV and tailored therapy for the patients are vital in prophylactic antiemetics therapy against gynecologic cancer chemotherapy.
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