Our goals in writing this commentary were to draw attention to RINV as common and underappreciated side effects of radiotherapy, to provide a summary of the evidence-based guidelines that describe optimal management strategies, and to discuss the current barriers to progress in RINV management and research.
In the future, national associations and individual institutions must take a leadership role by adapting existing antiemetic guidelines to their local environments, disseminating this information to their members, and monitoring and evaluating its implementation. Residency training programs must promote the importance of good antiemetic management among trainees. Economic analyses should be conducted to compare the costs of prophylactic therapies with those for rescue therapies and unplanned supportive care services. Cooperative groups must engage in both observational and interventional studies to support this important area of supportive care in cancer. Patient demographic risk factors for RINV need to be validated to allow for customized approaches to antiemetic therapy. The biological mechanisms underlying RINV, as well as the dosimetric radiotherapy variables predictive of RINV, must also be better elucidated to advance the field.
Expert Rev Pharmacoeconomics Outcomes Res. 2011;11(6):685-692. © 2011 Expert Reviews Ltd.