Las náuseas y vómitos en el paciente oncológico pueden deberse a diferentes causas, aunque frecuentemente se presentan en relación con los tratamientos de quimio y radioterapia. Sus tipos son: emesis aguda, que se presenta en las primeras 24 horas del tratamiento; retardada, que aparece posteriormente y puede durar varios días y anticipatoria, que sucede antes de administrarse la quimioterapia. Para su tratamiento se utilizan: inhibidores de receptores serotoninérgicos (ondansetrón, granisetrón y palonosetrón) que se utilizan frecuentemente combinados con esteroides (dexametasona); inhibidores del receptor de la neuroquinina (aprepitant y fosaprepitant); otros fármacos (fenotiacinas, haloperidol, metoclopramida, domperidona, benzodiacepinas, antiácidos, anticolinérgicos, cannabinoides…). Los citostáticos se clasifican como altamente emetógenos (se tratan con inhibidores de neuroquinina, antiserotoninérgicos y dexametasona), moderadamente emetógenos (se recomiendan antiserotoninérgicos, dexametasona y ocasionalmente inhibidores de la neuroquinina), de bajo riesgo (tratamiento con dexametasona) y mínimo riesgo (no requieren antieméticos profilácticos). Su eficacia debe reevaluarse en cada ciclo para adaptar el tratamiento a cada necesidad individual.

Nausea and vomiting in the cancer patient may have different causes. However, these frequently occur in relation to chemo- and radiotherapy treatments. Their types are: acute emesis, which occurs in the first 24 hours of treatment; delayed, which appears after and may last for several days; and anticipatory, which occurs prior to chemotherapy treatment. The following are used for their treatment: serotonin receptor inhibitors (ondansetron, granisetron and palonosetron), which are frequently used in combination with steroids (dexamethasone); neurokinin receptor inhibitors (aprepitant and fosaprepitant); other drugs (phenothiazines, haloperidol, metoclopramide, domperidone, benzodiazepines, antacids, anticholinergic, cannabinoids, etc.). Cytostatics are classified as highly emetogenic (they are treated with neurokinin inhibitors, antiserotoninergics and dexamethasone), moderately emetogenic (antiserotoninergics, dexamethasone and occasional neurokinin inhibitors are recommended), low risk (treatment with dexamethasone) and minimum risk (they do not require prophylactic antiemetics). Their efficacy should be reevaluated in each cycle to adapt the treatment to each individual need.