سامانه کنگره های دانشگاه علوم پزشکی و خدمات بهداشتی و درمانی آذربایجان غربی

صفحه اصلی / بیستمین همایش سالیانه بیماری های شایع گوارش و کبد کودکان ایران و دومین همایش بین المللی چاقی کودکان

Optimizing Prevention and Treatment of Chemotherapy-Induced Nausea and Vomiting in Pediatric Cancer Patients: A Systematic Review and Meta-Analysis

نویسندگان :

Yousef Tavakolifar¹ Aydin Mahmoud Alilou² Parinaz Mahmoud Alilou³ Amir Hossein Eskandari⁴ Amir Reza Bana Nasli⁵ Asal Khaksar Kolvanagh⁶ Alisan Khodayarlo⁷ Sina Manouchehrnia⁸ Pouria Shieeh⁹ Sana Nasirpour¹⁰ Meysam Najafi¹¹ Reza Rostami¹² Pardis Pour Ali¹³

1- دانشگاه علوم پزشکی تبریز 2- دانشگاه علوم پزشکی تبریز 3- دانشگاه علوم پزشکی تبریز 4- دانشگاه علوم پزشکی تبریز 5- دانشگاه علوم پزشکی تبریز 6- دانشگاه علوم پزشکی تبریز 7- دانشگاه علوم پزشکی تبریز 8- دانشگاه علوم پزشکی تبریز 9- دانشگاه علوم پزشکی تبریز 10- دانشگاه علوم پزشکی تبریز 11- دانشگاه علوم پزشکی تبریز 12- دانشگاه علوم پزشکی تبریز 13- دانشگاه علوم پزشکی تبریز

کلمات کلیدی :

Pediatric oncology،Chemotherapy-induced nausea and vomiting،Antiemetic guidelines،Palonosetron،Olanzapine

چکیده :

Background and Aim: Chemotherapy-induced nausea and vomiting (CINV) remain debilitating adverse effects in pediatric oncology, impacting treatment adherence and quality of life. Despite advancements in antiemetic therapies, optimal regimens for children are poorly defined. This meta-analysis evaluates the efficacy and safety of guideline-consistent antiemetic strategies in pediatric patients, focusing on acute and delayed CINV prevention. Methods: Individual patient data (IPD) from 12 prospective cohorts (2018–2023) were analyzed. Inclusion criteria: patients aged 1–18 years receiving moderately/highly emetogenic chemotherapy (MEC/HEC). Primary outcomes: complete CINV control (0–24h [acute], 25–120h [delayed]). Secondary outcomes: adverse events, risk factors for breakthrough CINV. Results: Among 1,502 patients, triple therapy (5-HT3 antagonist + dexamethasone + NK1 antagonist) achieved 88% acute CINV control (95% CI: 84–91%) vs. 72% with dual therapy (5-HT3 antagonist + dexamethasone). Delayed CINV control declined to 62% with triple therapy. Palonosetron outperformed ondansetron in delayed control (RR=1.28, p=0.003). Olanzapine adjunct therapy reduced refractory nausea (RR=1.35, p=0.01). Major adverse events: sedation (15%), hypertension (8%). Conclusion: Triple therapy remains the cornerstone for acute CINV prevention, while palonosetron and olanzapine enhance delayed control. Personalized protocols based on emetogenicity and patient-specific risks are critical for optimizing outcomes.

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