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Current Oncology
Volume 14
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Article

Prevention and Management of Chemotherapy-Induced Diarrhea in Patients with Colorectal Cancer: A Consensus Statement by the Canadian Working Group on Chemotherapy-Induced Diarrhea

by
J. A. Maroun
1,*,
L. B. Anthony
2,
N. Blais
3,
R. Burkes
4,
S. D. Dowden
5,
G. Dranitsaris
6,
B. Samson
7,
A. Shah
8,
M. P. Thirlwell
9,
M. D. Vincent
10 and
R. Wong
11
1
Ottawa Hospital Regional Cancer Centre, Ottawa, ON, Canada
2
University Hospital, LSUHSC New Orleans, New Orleans, LA, USA
3
Notre-Dame Hospital, CHUM, Montreal, QC, Canada
4
Mount Sinai Hospital, Princess Margaret Hospital/UHN, Toronto, ON, Canada
5
Tom Baker Cancer Centre, Calgary, AB, Canada
6
Outcomes research consultant, Toronto, ON, Canada
7
Hôpital Charles-Lemoyne, Greenfield Park, QC, Canada
8
BC Cancer Agency, University of British Columbia, Vancouver, BC, Canada
9
Montreal General Hospital, Montreal, QC, Canada
10
London Health Sciences Centre, London, ON, Canada
11
St. Boniface General Hospital, Winnipeg, MB, Canada
 
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*
Author to whom correspondence should be addressed.
Curr. Oncol. 2007, 14(1), 13-20; https://doi.org/10.3747/co.2007.96
Submission received: 3 November 2006 / Revised: 7 December 2006 / Accepted: 11 January 2007 / Published: 1 February 2007

Abstract

Chemotherapy-induced diarrhea (cid) is a common side effect of cancer treatment and can cause significant morbidity and mortality. Diarrhea is frequently severe enough to require a dose reduction of, a delay in, or a discontinuation of chemotherapy. Diarrhea-associated mortality has been reported to be as high as 3.5% in clinical trials of irinotecan and bolus 5-fluorouracil in colorectal cancer. The frequency of cid and its impact on patient management are frequently under-recognized in clinical practice. A Canadian working group, consisting of medical oncologists and an oncology pharmacist, was formed in 2001 to review the optimal approach to managing cid and to identify and implement new areas of research. The recommendations that follow are the result of the group’s work. Acute medical management of cid includes loperamide or diphenoxylate as first-line agents. Subcutaneous octreotide is recommended for intractable grade 2 diarrhea and may be considered for grade 1 cid that does not resolve with high-dose loperamide. Hospitalization is recommended for patients with grades 3 and 4 cid; in-hospital care includes rehydration, antibiotic therapy, and octreotide. A chemotherapy dose reduction is generally advised for patients who have experienced grade 3 or 4 diarrhea in a previous chemotherapy cycle. If a dose reduction is not desired, prophylaxis with intramuscular long-acting release octreotide may be considered. The foregoing recommendations are based on expert opinion and require validation in prospective clinical trials.
Keywords: chemotherapy; diarrhea; cid; octreotide; 5-fu; irinotecan; prophylaxis; management chemotherapy; diarrhea; cid; octreotide; 5-fu; irinotecan; prophylaxis; management

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MDPI and ACS Style

Maroun, J.A.; Anthony, L.B.; Blais, N.; Burkes, R.; Dowden, S.D.; Dranitsaris, G.; Samson, B.; Shah, A.; Thirlwell, M.P.; Vincent, M.D.; et al. Prevention and Management of Chemotherapy-Induced Diarrhea in Patients with Colorectal Cancer: A Consensus Statement by the Canadian Working Group on Chemotherapy-Induced Diarrhea. Curr. Oncol. 2007, 14, 13-20. https://doi.org/10.3747/co.2007.96

AMA Style

Maroun JA, Anthony LB, Blais N, Burkes R, Dowden SD, Dranitsaris G, Samson B, Shah A, Thirlwell MP, Vincent MD, et al. Prevention and Management of Chemotherapy-Induced Diarrhea in Patients with Colorectal Cancer: A Consensus Statement by the Canadian Working Group on Chemotherapy-Induced Diarrhea. Current Oncology. 2007; 14(1):13-20. https://doi.org/10.3747/co.2007.96

Chicago/Turabian Style

Maroun, J. A., L. B. Anthony, N. Blais, R. Burkes, S. D. Dowden, G. Dranitsaris, B. Samson, A. Shah, M. P. Thirlwell, M. D. Vincent, and et al. 2007. "Prevention and Management of Chemotherapy-Induced Diarrhea in Patients with Colorectal Cancer: A Consensus Statement by the Canadian Working Group on Chemotherapy-Induced Diarrhea" Current Oncology 14, no. 1: 13-20. https://doi.org/10.3747/co.2007.96

APA Style

Maroun, J. A., Anthony, L. B., Blais, N., Burkes, R., Dowden, S. D., Dranitsaris, G., Samson, B., Shah, A., Thirlwell, M. P., Vincent, M. D., & Wong, R. (2007). Prevention and Management of Chemotherapy-Induced Diarrhea in Patients with Colorectal Cancer: A Consensus Statement by the Canadian Working Group on Chemotherapy-Induced Diarrhea. Current Oncology, 14(1), 13-20. https://doi.org/10.3747/co.2007.96

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