Management of cancer treatment-related diarrhea. Issues and therapeutic strategies.

Abstract

The cancer treatment-related diarrhea caused by acute graft-versus-host disease (GVHD) and chemotherapeutic agents, particularly fluoropyrimidines and irinotecan, significantly affects patient morbidity and mortality. The mechanisms causing cancer treatment-related diarrhea are not fully understood, but histopathologic evidence points to a multifactorial process that causes an absorptive and secretory imbalance in the small bowel. Cancer treatment-related diarrhea could be life-threatening, yet assessment and treatment are not currently standardized. Several clinicians participated in a closed roundtable meeting to review the mechanisms of chemotherapy-induced diarrhea (CID) and GVHD-induced diarrhea, management issues in cancer treatment-induced diarrhea, and pharmacologic approaches to treatment. The meeting produced a proposal for new treatment guidelines and an algorithm, which include the use of octreotide for the management of CID- and GVHD-induced diarrhea. The development of diarrhea assessment guidelines that expand on the current National Cancer Institute criteria and allow for better patient management was also proposed.

• Authors: S Kornblau, A B Benson, R Catalano, R E Champlin, C Engelking, M Field, C Ippoliti, H M Lazarus, E Mitchell, J Rubin, P J Stiff, E Vokes, S Wadler
• Journal: Journal of pain and symptom management (J Pain Symptom Manage) Vol. 19 Issue 2 Pg. 118-29 (Feb 2000) ISSN: 0885-3924 [Print] United States
• PMID: 10699539 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Antineoplastic Agents

Topics

• Antineoplastic Agents (adverse effects)
• Diarrhea (chemically induced, drug therapy, etiology)
• Graft vs Host Disease (complications)
• Humans
• Neoplasms (therapy)
• Practice Guidelines as Topic