Abstract：
OBJECTIVE: This study describes chemotherapy-induced nausea and vomiting (CINV) control rates in pediatric and adult patients who did or did not receive guideline-consistent CINV prophylaxis.
METHODS: We conducted a systematic literature review of studies published in 2000 or later that evaluated CINV control in patients receiving guideline-consistent vs. guideline-inconsistent CINV prophylaxis and reported at least one CINV-related patient outcome. Studies were excluded if the guideline evaluated was not publicly available or not developed by a professional organization. Over-prophylaxis was defined as antiemetic use recommended for a higher level of chemotherapy emetogenicity than a patient was receiving.
RESULTS: We identified 7060 citations and retrieved 141 publications for full-text evaluation. Of these, 21 publications (14 prospective and seven retrospective studies) evaluating guidelines developed by six organizations were included. The terms used to describe CINV endpoints and definition of guideline-consistent CINV prophylaxis varied among studies. Included studies either did not address over-prophylaxis in their definition of guideline-consistent CINV prophylaxis (48%; 10/21) or defined it as guideline-inconsistent (38%; 8/21) or guideline-consistent (3/21; 14%). Eleven included studies (52%; 11/21) reported a clinically meaningful improvement in at least one CINV endpoint in patients receiving guideline-consistent CINV prophylaxis. Ten reported a statistically significant improvement.
CONCLUSIONS: This evidence supports the use of guideline-consistent prophylaxis to optimize CINV control. Institutions caring for patients with cancer should systematically adapt CINV CPGs for local implementation and routinely evaluate CINV outcomes.
METHODS: We conducted a systematic literature review of studies published in 2000 or later that evaluated CINV control in patients receiving guideline-consistent vs. guideline-inconsistent CINV prophylaxis and reported at least one CINV-related patient outcome. Studies were excluded if the guideline evaluated was not publicly available or not developed by a professional organization. Over-prophylaxis was defined as antiemetic use recommended for a higher level of chemotherapy emetogenicity than a patient was receiving.
RESULTS: We identified 7060 citations and retrieved 141 publications for full-text evaluation. Of these, 21 publications (14 prospective and seven retrospective studies) evaluating guidelines developed by six organizations were included. The terms used to describe CINV endpoints and definition of guideline-consistent CINV prophylaxis varied among studies. Included studies either did not address over-prophylaxis in their definition of guideline-consistent CINV prophylaxis (48%; 10/21) or defined it as guideline-inconsistent (38%; 8/21) or guideline-consistent (3/21; 14%). Eleven included studies (52%; 11/21) reported a clinically meaningful improvement in at least one CINV endpoint in patients receiving guideline-consistent CINV prophylaxis. Ten reported a statistically significant improvement.
CONCLUSIONS: This evidence supports the use of guideline-consistent prophylaxis to optimize CINV control. Institutions caring for patients with cancer should systematically adapt CINV CPGs for local implementation and routinely evaluate CINV outcomes.
摘要：
目的：本研究描述了接受或未接受指南一致的CI-NV预防的儿童和成人患者化疗引起的恶心和呕吐（CINV）控制率。
方法：我们对2000年或以后发表的研究进行了系统的文献综述，这些研究评估了接受指南一致的患者的CINV控制与指南不一致CINV预防，并报告至少一个CINV相关患者结局。如果评估的指南不是公开可用的或不是由专业组织开发的，则排除研究。过度预防被定义为建议使用止吐剂用于比患者接受更高水平的化疗。
结果：我们确定了7060篇引文，并检索了141篇出版物用于全文评估。其中,纳入了由六个组织制定的评估指南的21篇出版物（14项前瞻性研究和7项回顾性研究）。用于描述CINV终点和指南一致CINV预防定义的术语在研究中有所不同。纳入的研究在其指南一致性CINV预防的定义中没有解决过度预防(48%;10/21)或将其定义为指南不一致(38%;8/21)或指南一致性(3/21;14%)。11项纳入研究（52％;11/21）报告了在接受指南一致CINV预防的患者中至少一个CINV终点有临床意义的改善。十个报告了统计学上的显着改善。
结论：该证据支持使用指南一致的预防来优化CINV控制。照顾癌症患者的机构应系统地调整CINVCPG，以便在当地实施，并常规评估CINV结果。
方法：我们对2000年或以后发表的研究进行了系统的文献综述，这些研究评估了接受指南一致的患者的CINV控制与指南不一致CINV预防，并报告至少一个CINV相关患者结局。如果评估的指南不是公开可用的或不是由专业组织开发的，则排除研究。过度预防被定义为建议使用止吐剂用于比患者接受更高水平的化疗。
结果：我们确定了7060篇引文，并检索了141篇出版物用于全文评估。其中,纳入了由六个组织制定的评估指南的21篇出版物（14项前瞻性研究和7项回顾性研究）。用于描述CINV终点和指南一致CINV预防定义的术语在研究中有所不同。纳入的研究在其指南一致性CINV预防的定义中没有解决过度预防(48%;10/21)或将其定义为指南不一致(38%;8/21)或指南一致性(3/21;14%)。11项纳入研究（52％;11/21）报告了在接受指南一致CINV预防的患者中至少一个CINV终点有临床意义的改善。十个报告了统计学上的显着改善。
结论：该证据支持使用指南一致的预防来优化CINV控制。照顾癌症患者的机构应系统地调整CINVCPG，以便在当地实施，并常规评估CINV结果。
