Cytotoxic treatment-induced gastrointestinal symptoms.
OBJECTIVE
This review highlights recent updates in cytotoxic treatment-induced gastrointestinal symptoms and complications, outlines the development of new diagnostic tools, and offers an up-to-date overview on management.


RESULTS
The neurokinin-1 receptor antagonist, aprepitant, has consolidated its attributive role in the prevention of acute phase chemotherapy-induced nausea and vomiting. Delayed gastrointestinal symptomatology related to the process of cytotoxic treatment-induced mucosal damage needs to be better understood in order to enable the clinician to assess gastrointestinal mucosal damage properly by documenting symptomatology, testing functionality and visualizing anatomical changes. By contrast to the proven beneficial effects of new drugs, such as palifermin (a trophic epidermal growth factor) or amifostine (free radical scavenger), in the management of oral mucositis, efficacy still needs to be determined regarding its gastrointestinal counterpart.


CONCLUSIONS
Gastrointestinal symptoms originating from cytotoxic treatment-induced mucosal barrier injury are the clinical features of a complex, dynamic pathobiological process that diminishes the quality of life but, more importantly, places the patient at risk for serious complications, like neutropenic enterocolitis. It is crucial, therefore, to adequately detect mucosal barrier injury using a complementary approach that will allow new therapeutic options to be tested thoroughly and improve supportive care.
Blijlevens
Nicole M A
NM
Department of Haematology, University Medical Centre, St Radboud, Nijmegen, The Netherlands. n.blijlevens@hemat.umcn.nl
D000932:Antiemetics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000077608:Aprepitant; D044504:Enterocolitis, Neutropenic / Q000139:chemically induced; D006801:Humans; D009025:Morpholines / Q000627:therapeutic use; D052016:Mucositis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D009325:Nausea / Q000139:chemically induced* / Q000517:prevention & control; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D064729:Neurokinin-1 Receptor Antagonists; D018040:Receptors, Neurokinin-1 / Q000378:metabolism / Q000627:therapeutic use; D012307:Risk Factors; D014839:Vomiting / Q000139:chemically induced* / Q000517:prevention & control
D000932:Antiemetics; D000970:Antineoplastic Agents; D009025:Morpholines; D064729:Neurokinin-1 Receptor Antagonists; D018040:Receptors, Neurokinin-1; D000077608:Aprepitant