Managing Hyperemesis in the Era of Concurrent and Sequential Chemo-radiation

Nausea and vomiting are most common adverse effects experienced by cancer patients affecting almost 60–80% patients. Various factors determine the likelihood and severity, like sex, age, intrinsic emetogenicity, route of administration and dosage, schedule and area of radiotherapy. Availability of prophylactic measures have markedly reduced anticipatory emetic syndrome. Chemotherapeutic agents are classified on basis of emetogenic potential. Heskith classified them into four groups comprising of highly, moderately, low and minimally emetogenic. Prophylactic strategies should encompass both acute and delayed phases. With adequate formulations of prophylactic strategies, nausea and vomiting can be prevented in majority of patients.