title: 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.affiliation: University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4095, USA.
authors.forename: S
authors.initials: S
authors.lastname: Kornblau
authors.forename: A B
authors.initials: AB
authors.lastname: Benson
authors.forename: R
authors.initials: R
authors.lastname: Catalano
authors.forename: R E
authors.initials: RE
authors.lastname: Champlin
authors.forename: C
authors.initials: C
authors.lastname: Engelking
authors.forename: M
authors.initials: M
authors.lastname: Field
authors.forename: C
authors.initials: C
authors.lastname: Ippoliti
authors.forename: H M
authors.initials: HM
authors.lastname: Lazarus
authors.forename: E
authors.initials: E
authors.lastname: Mitchell
authors.forename: J
authors.initials: J
authors.lastname: Rubin
authors.forename: P J
authors.initials: PJ
authors.lastname: Stiff
authors.forename: E
authors.initials: E
authors.lastname: Vokes
authors.forename: S
authors.initials: S
authors.lastname: Wadler
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D003967:Diarrhea / Q000139:chemically induced* / Q000188:drug therapy / Q000209:etiology*; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D009369:Neoplasms / Q000628:therapy; D017410:Practice Guidelines as Topic
chemical_list: D000970:Antineoplastic Agents