Risk and outcomes of chemotherapy-induced diarrhea (CID) among patients with colorectal cancer receiving multi-cycle chemotherapy
Background Diarrhea is a common toxicity of chemotherapy, but the practice of reporting only severe grades (≥ 3) in clinical trials results in misleading conclusions of significance. Epidemiology remains poorly described, and effects of multi-cycle regimens have not been investigated. To better unde...
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| Veröffentlicht in: | Cancer chemotherapy and pharmacology 2014-10, Vol.74 (4), p.675-680 |
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| creator | Keefe, Dorothy M. Elting, Linda S. Nguyen, Hoang T. Grunberg, Steven M. Aprile, Giuseppe Bonaventura, Antony Selva-Nayagam, Sudarsha Barsevick, Andrea Koczwara, Bogda Sonis, Stephen T. |
| description | Background
Diarrhea is a common toxicity of chemotherapy, but the practice of reporting only severe grades (≥ 3) in clinical trials results in misleading conclusions of significance. Epidemiology remains poorly described, and effects of multi-cycle regimens have not been investigated. To better understand the risks, symptom burden and consequences of CID, we studied patients receiving chemotherapy for colorectal cancer (CRC).
Methods
One hundred and fourteen patients receiving FOLFOX (95 patients, 530 cycles), FOLFOX + monoclonal antibodies (10 patients, 49 cycles) or FOLFIRI (9 patients, 50 cycles) were enrolled. CID was identified from diaries at baseline and daily during up to 8 chemotherapy cycles using supplemental questions on the Oral Mucositis Daily Questionnaire, a valid tool for collecting patient-reported outcomes of regimen-related mucosal injury. Patients scored CID severity from 0 “none” to 10 “worst possible,” and quantity from “little” to “severe” on a 5-point scale. Quality of life was measured using the FACT-G, and fatigue using the FACIT fatigue scale.
Results
CID occurred in 89 % of patients on FOLFIRI, 50 % on FOLFOX + monoclonal antibodies and 56 % on FOLFOX alone. The risk of a first episode was highest during Cycle 1 (35 %) and dropped to |
| doi_str_mv | 10.1007/s00280-014-2526-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1564557136</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3441665901</sourcerecordid><originalsourceid>FETCH-LOGICAL-c472t-72751cc59a96737cca6cf61de31cd68085cdd44e324397d0c775e029cb0dcd03</originalsourceid><addsrcrecordid>eNp1kM9rFTEQx4Mo9ln9A7xIQIR6iE5-bXaP5VltoSBI70s6yfal7m6eSVZ5x_7nTXlPrQdPwzCf-c7wIeQ1hw8cwHzMAKIFBlwxoUXD9BOy4koKBq2ST8kKpFJMG1BH5EXOtwCguJTPyZHQoHUn9YrcfQv5O7Wzo3EpGCefaRwobvwUy8Ynu92xMLsFvaMu2JQ23tKT9cWn99ROcb6hW1uCn0umv0LZUIxjTB6LHSnaGX2itfPhZ6jktIwlMNzh6P_Jf0meDXbM_tWhHpOrz2dX63N2-fXLxfr0kqEyojAjjOaIurNdY6RBtA0ODXdecnRNC61G55TyUijZGQdojPYgOrwGhw7kMXm7j92m-GPxufS3cUlzvdhz3SitDZdNpfiewhRzTn7otylMNu16Dv2D837vvK_O-wfnva47bw7Jy_Xk3Z-N35Ir8O4A2Ix2HFJVE_Jfrm07kKKrnNhzuY7mG58evfjf6_fhD5qq</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1564557136</pqid></control><display><type>article</type><title>Risk and outcomes of chemotherapy-induced diarrhea (CID) among patients with colorectal cancer receiving multi-cycle chemotherapy</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Keefe, Dorothy M. ; Elting, Linda S. ; Nguyen, Hoang T. ; Grunberg, Steven M. ; Aprile, Giuseppe ; Bonaventura, Antony ; Selva-Nayagam, Sudarsha ; Barsevick, Andrea ; Koczwara, Bogda ; Sonis, Stephen T.</creator><creatorcontrib>Keefe, Dorothy M. ; Elting, Linda S. ; Nguyen, Hoang T. ; Grunberg, Steven M. ; Aprile, Giuseppe ; Bonaventura, Antony ; Selva-Nayagam, Sudarsha ; Barsevick, Andrea ; Koczwara, Bogda ; Sonis, Stephen T.</creatorcontrib><description>Background
Diarrhea is a common toxicity of chemotherapy, but the practice of reporting only severe grades (≥ 3) in clinical trials results in misleading conclusions of significance. Epidemiology remains poorly described, and effects of multi-cycle regimens have not been investigated. To better understand the risks, symptom burden and consequences of CID, we studied patients receiving chemotherapy for colorectal cancer (CRC).
Methods
One hundred and fourteen patients receiving FOLFOX (95 patients, 530 cycles), FOLFOX + monoclonal antibodies (10 patients, 49 cycles) or FOLFIRI (9 patients, 50 cycles) were enrolled. CID was identified from diaries at baseline and daily during up to 8 chemotherapy cycles using supplemental questions on the Oral Mucositis Daily Questionnaire, a valid tool for collecting patient-reported outcomes of regimen-related mucosal injury. Patients scored CID severity from 0 “none” to 10 “worst possible,” and quantity from “little” to “severe” on a 5-point scale. Quality of life was measured using the FACT-G, and fatigue using the FACIT fatigue scale.
Results
CID occurred in 89 % of patients on FOLFIRI, 50 % on FOLFOX + monoclonal antibodies and 56 % on FOLFOX alone. The risk of a first episode was highest during Cycle 1 (35 %) and dropped to <10 % during Cycles 3–5. Patients with CID reported poorer quality of life scores than those without CID (77.1 vs 80.7).
Conclusions
Diarrhea occurs more commonly than typically appreciated during chemotherapy for CRC. Risk is highest during first exposure, suggesting variable susceptibility. Identification of this high-risk subgroup for prophylaxis could improve the quality of life.</description><identifier>ISSN: 0344-5704</identifier><identifier>EISSN: 1432-0843</identifier><identifier>DOI: 10.1007/s00280-014-2526-5</identifier><identifier>PMID: 25055935</identifier><identifier>CODEN: CCPHDZ</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject><![CDATA[Antibodies, Monoclonal - administration & dosage ; Antibodies, Monoclonal - adverse effects ; Antineoplastic agents ; Antineoplastic Agents - administration & dosage ; Antineoplastic Agents - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Australia - epidemiology ; Biological and medical sciences ; Camptothecin - administration & dosage ; Camptothecin - adverse effects ; Camptothecin - analogs & derivatives ; Canada - epidemiology ; Cancer Research ; Colorectal Neoplasms - drug therapy ; Colorectal Neoplasms - pathology ; Colorectal Neoplasms - psychology ; Diarrhea - chemically induced ; Diarrhea - diagnosis ; Diarrhea - epidemiology ; Diarrhea - physiopathology ; Diarrhea - prevention & control ; Drug Screening Assays, Antitumor ; Europe - epidemiology ; Female ; Fluorouracil - administration & dosage ; Fluorouracil - adverse effects ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Immunologic Factors - administration & dosage ; Immunologic Factors - adverse effects ; Leucovorin - administration & dosage ; Leucovorin - adverse effects ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Neoplasm Staging ; Oncology ; Organoplatinum Compounds - administration & dosage ; Organoplatinum Compounds - adverse effects ; Original Article ; Other diseases. Semiology ; Pharmacology. Drug treatments ; Pharmacology/Toxicology ; Prevalence ; Quality of Life ; Risk Assessment ; Severity of Illness Index ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surveys and Questionnaires ; Treatment Outcome ; Tumors ; United States - epidemiology]]></subject><ispartof>Cancer chemotherapy and pharmacology, 2014-10, Vol.74 (4), p.675-680</ispartof><rights>Springer-Verlag Berlin Heidelberg 2014</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c472t-72751cc59a96737cca6cf61de31cd68085cdd44e324397d0c775e029cb0dcd03</citedby><cites>FETCH-LOGICAL-c472t-72751cc59a96737cca6cf61de31cd68085cdd44e324397d0c775e029cb0dcd03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00280-014-2526-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00280-014-2526-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28890329$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25055935$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Keefe, Dorothy M.</creatorcontrib><creatorcontrib>Elting, Linda S.</creatorcontrib><creatorcontrib>Nguyen, Hoang T.</creatorcontrib><creatorcontrib>Grunberg, Steven M.</creatorcontrib><creatorcontrib>Aprile, Giuseppe</creatorcontrib><creatorcontrib>Bonaventura, Antony</creatorcontrib><creatorcontrib>Selva-Nayagam, Sudarsha</creatorcontrib><creatorcontrib>Barsevick, Andrea</creatorcontrib><creatorcontrib>Koczwara, Bogda</creatorcontrib><creatorcontrib>Sonis, Stephen T.</creatorcontrib><title>Risk and outcomes of chemotherapy-induced diarrhea (CID) among patients with colorectal cancer receiving multi-cycle chemotherapy</title><title>Cancer chemotherapy and pharmacology</title><addtitle>Cancer Chemother Pharmacol</addtitle><addtitle>Cancer Chemother Pharmacol</addtitle><description>Background
Diarrhea is a common toxicity of chemotherapy, but the practice of reporting only severe grades (≥ 3) in clinical trials results in misleading conclusions of significance. Epidemiology remains poorly described, and effects of multi-cycle regimens have not been investigated. To better understand the risks, symptom burden and consequences of CID, we studied patients receiving chemotherapy for colorectal cancer (CRC).
Methods
One hundred and fourteen patients receiving FOLFOX (95 patients, 530 cycles), FOLFOX + monoclonal antibodies (10 patients, 49 cycles) or FOLFIRI (9 patients, 50 cycles) were enrolled. CID was identified from diaries at baseline and daily during up to 8 chemotherapy cycles using supplemental questions on the Oral Mucositis Daily Questionnaire, a valid tool for collecting patient-reported outcomes of regimen-related mucosal injury. Patients scored CID severity from 0 “none” to 10 “worst possible,” and quantity from “little” to “severe” on a 5-point scale. Quality of life was measured using the FACT-G, and fatigue using the FACIT fatigue scale.
Results
CID occurred in 89 % of patients on FOLFIRI, 50 % on FOLFOX + monoclonal antibodies and 56 % on FOLFOX alone. The risk of a first episode was highest during Cycle 1 (35 %) and dropped to <10 % during Cycles 3–5. Patients with CID reported poorer quality of life scores than those without CID (77.1 vs 80.7).
Conclusions
Diarrhea occurs more commonly than typically appreciated during chemotherapy for CRC. Risk is highest during first exposure, suggesting variable susceptibility. Identification of this high-risk subgroup for prophylaxis could improve the quality of life.</description><subject>Antibodies, Monoclonal - administration & dosage</subject><subject>Antibodies, Monoclonal - adverse effects</subject><subject>Antineoplastic agents</subject><subject>Antineoplastic Agents - administration & dosage</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Australia - epidemiology</subject><subject>Biological and medical sciences</subject><subject>Camptothecin - administration & dosage</subject><subject>Camptothecin - adverse effects</subject><subject>Camptothecin - analogs & derivatives</subject><subject>Canada - epidemiology</subject><subject>Cancer Research</subject><subject>Colorectal Neoplasms - drug therapy</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Colorectal Neoplasms - psychology</subject><subject>Diarrhea - chemically induced</subject><subject>Diarrhea - diagnosis</subject><subject>Diarrhea - epidemiology</subject><subject>Diarrhea - physiopathology</subject><subject>Diarrhea - prevention & control</subject><subject>Drug Screening Assays, Antitumor</subject><subject>Europe - epidemiology</subject><subject>Female</subject><subject>Fluorouracil - administration & dosage</subject><subject>Fluorouracil - adverse effects</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Immunologic Factors - administration & dosage</subject><subject>Immunologic Factors - adverse effects</subject><subject>Leucovorin - administration & dosage</subject><subject>Leucovorin - adverse effects</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Organoplatinum Compounds - administration & dosage</subject><subject>Organoplatinum Compounds - adverse effects</subject><subject>Original Article</subject><subject>Other diseases. Semiology</subject><subject>Pharmacology. Drug treatments</subject><subject>Pharmacology/Toxicology</subject><subject>Prevalence</subject><subject>Quality of Life</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surveys and Questionnaires</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>United States - epidemiology</subject><issn>0344-5704</issn><issn>1432-0843</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kM9rFTEQx4Mo9ln9A7xIQIR6iE5-bXaP5VltoSBI70s6yfal7m6eSVZ5x_7nTXlPrQdPwzCf-c7wIeQ1hw8cwHzMAKIFBlwxoUXD9BOy4koKBq2ST8kKpFJMG1BH5EXOtwCguJTPyZHQoHUn9YrcfQv5O7Wzo3EpGCefaRwobvwUy8Ynu92xMLsFvaMu2JQ23tKT9cWn99ROcb6hW1uCn0umv0LZUIxjTB6LHSnaGX2itfPhZ6jktIwlMNzh6P_Jf0meDXbM_tWhHpOrz2dX63N2-fXLxfr0kqEyojAjjOaIurNdY6RBtA0ODXdecnRNC61G55TyUijZGQdojPYgOrwGhw7kMXm7j92m-GPxufS3cUlzvdhz3SitDZdNpfiewhRzTn7otylMNu16Dv2D837vvK_O-wfnva47bw7Jy_Xk3Z-N35Ir8O4A2Ix2HFJVE_Jfrm07kKKrnNhzuY7mG58evfjf6_fhD5qq</recordid><startdate>20141001</startdate><enddate>20141001</enddate><creator>Keefe, Dorothy M.</creator><creator>Elting, Linda S.</creator><creator>Nguyen, Hoang T.</creator><creator>Grunberg, Steven M.</creator><creator>Aprile, Giuseppe</creator><creator>Bonaventura, Antony</creator><creator>Selva-Nayagam, Sudarsha</creator><creator>Barsevick, Andrea</creator><creator>Koczwara, Bogda</creator><creator>Sonis, Stephen T.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope></search><sort><creationdate>20141001</creationdate><title>Risk and outcomes of chemotherapy-induced diarrhea (CID) among patients with colorectal cancer receiving multi-cycle chemotherapy</title><author>Keefe, Dorothy M. ; Elting, Linda S. ; Nguyen, Hoang T. ; Grunberg, Steven M. ; Aprile, Giuseppe ; Bonaventura, Antony ; Selva-Nayagam, Sudarsha ; Barsevick, Andrea ; Koczwara, Bogda ; Sonis, Stephen T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c472t-72751cc59a96737cca6cf61de31cd68085cdd44e324397d0c775e029cb0dcd03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Antibodies, Monoclonal - administration & dosage</topic><topic>Antibodies, Monoclonal - adverse effects</topic><topic>Antineoplastic agents</topic><topic>Antineoplastic Agents - administration & dosage</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Australia - epidemiology</topic><topic>Biological and medical sciences</topic><topic>Camptothecin - administration & dosage</topic><topic>Camptothecin - adverse effects</topic><topic>Camptothecin - analogs & derivatives</topic><topic>Canada - epidemiology</topic><topic>Cancer Research</topic><topic>Colorectal Neoplasms - drug therapy</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Colorectal Neoplasms - psychology</topic><topic>Diarrhea - chemically induced</topic><topic>Diarrhea - diagnosis</topic><topic>Diarrhea - epidemiology</topic><topic>Diarrhea - physiopathology</topic><topic>Diarrhea - prevention & control</topic><topic>Drug Screening Assays, Antitumor</topic><topic>Europe - epidemiology</topic><topic>Female</topic><topic>Fluorouracil - administration & dosage</topic><topic>Fluorouracil - adverse effects</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Immunologic Factors - administration & dosage</topic><topic>Immunologic Factors - adverse effects</topic><topic>Leucovorin - administration & dosage</topic><topic>Leucovorin - adverse effects</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multiple tumors. Solid tumors. Tumors in childhood (general aspects)</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Organoplatinum Compounds - administration & dosage</topic><topic>Organoplatinum Compounds - adverse effects</topic><topic>Original Article</topic><topic>Other diseases. Semiology</topic><topic>Pharmacology. Drug treatments</topic><topic>Pharmacology/Toxicology</topic><topic>Prevalence</topic><topic>Quality of Life</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surveys and Questionnaires</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Keefe, Dorothy M.</creatorcontrib><creatorcontrib>Elting, Linda S.</creatorcontrib><creatorcontrib>Nguyen, Hoang T.</creatorcontrib><creatorcontrib>Grunberg, Steven M.</creatorcontrib><creatorcontrib>Aprile, Giuseppe</creatorcontrib><creatorcontrib>Bonaventura, Antony</creatorcontrib><creatorcontrib>Selva-Nayagam, Sudarsha</creatorcontrib><creatorcontrib>Barsevick, Andrea</creatorcontrib><creatorcontrib>Koczwara, Bogda</creatorcontrib><creatorcontrib>Sonis, Stephen T.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><jtitle>Cancer chemotherapy and pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Keefe, Dorothy M.</au><au>Elting, Linda S.</au><au>Nguyen, Hoang T.</au><au>Grunberg, Steven M.</au><au>Aprile, Giuseppe</au><au>Bonaventura, Antony</au><au>Selva-Nayagam, Sudarsha</au><au>Barsevick, Andrea</au><au>Koczwara, Bogda</au><au>Sonis, Stephen T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk and outcomes of chemotherapy-induced diarrhea (CID) among patients with colorectal cancer receiving multi-cycle chemotherapy</atitle><jtitle>Cancer chemotherapy and pharmacology</jtitle><stitle>Cancer Chemother Pharmacol</stitle><addtitle>Cancer Chemother Pharmacol</addtitle><date>2014-10-01</date><risdate>2014</risdate><volume>74</volume><issue>4</issue><spage>675</spage><epage>680</epage><pages>675-680</pages><issn>0344-5704</issn><eissn>1432-0843</eissn><coden>CCPHDZ</coden><abstract>Background
Diarrhea is a common toxicity of chemotherapy, but the practice of reporting only severe grades (≥ 3) in clinical trials results in misleading conclusions of significance. Epidemiology remains poorly described, and effects of multi-cycle regimens have not been investigated. To better understand the risks, symptom burden and consequences of CID, we studied patients receiving chemotherapy for colorectal cancer (CRC).
Methods
One hundred and fourteen patients receiving FOLFOX (95 patients, 530 cycles), FOLFOX + monoclonal antibodies (10 patients, 49 cycles) or FOLFIRI (9 patients, 50 cycles) were enrolled. CID was identified from diaries at baseline and daily during up to 8 chemotherapy cycles using supplemental questions on the Oral Mucositis Daily Questionnaire, a valid tool for collecting patient-reported outcomes of regimen-related mucosal injury. Patients scored CID severity from 0 “none” to 10 “worst possible,” and quantity from “little” to “severe” on a 5-point scale. Quality of life was measured using the FACT-G, and fatigue using the FACIT fatigue scale.
Results
CID occurred in 89 % of patients on FOLFIRI, 50 % on FOLFOX + monoclonal antibodies and 56 % on FOLFOX alone. The risk of a first episode was highest during Cycle 1 (35 %) and dropped to <10 % during Cycles 3–5. Patients with CID reported poorer quality of life scores than those without CID (77.1 vs 80.7).
Conclusions
Diarrhea occurs more commonly than typically appreciated during chemotherapy for CRC. Risk is highest during first exposure, suggesting variable susceptibility. Identification of this high-risk subgroup for prophylaxis could improve the quality of life.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25055935</pmid><doi>10.1007/s00280-014-2526-5</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Cancer chemotherapy and pharmacology, 2014-10, Vol.74 (4), p.675-680 |
| issn | 0344-5704 1432-0843 |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Antibodies, Monoclonal - administration & dosage Antibodies, Monoclonal - adverse effects Antineoplastic agents Antineoplastic Agents - administration & dosage Antineoplastic Agents - adverse effects Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - adverse effects Australia - epidemiology Biological and medical sciences Camptothecin - administration & dosage Camptothecin - adverse effects Camptothecin - analogs & derivatives Canada - epidemiology Cancer Research Colorectal Neoplasms - drug therapy Colorectal Neoplasms - pathology Colorectal Neoplasms - psychology Diarrhea - chemically induced Diarrhea - diagnosis Diarrhea - epidemiology Diarrhea - physiopathology Diarrhea - prevention & control Drug Screening Assays, Antitumor Europe - epidemiology Female Fluorouracil - administration & dosage Fluorouracil - adverse effects Gastroenterology. Liver. Pancreas. Abdomen Humans Immunologic Factors - administration & dosage Immunologic Factors - adverse effects Leucovorin - administration & dosage Leucovorin - adverse effects Male Medical sciences Medicine Medicine & Public Health Middle Aged Multiple tumors. Solid tumors. Tumors in childhood (general aspects) Neoplasm Staging Oncology Organoplatinum Compounds - administration & dosage Organoplatinum Compounds - adverse effects Original Article Other diseases. Semiology Pharmacology. Drug treatments Pharmacology/Toxicology Prevalence Quality of Life Risk Assessment Severity of Illness Index Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surveys and Questionnaires Treatment Outcome Tumors United States - epidemiology |
| title | Risk and outcomes of chemotherapy-induced diarrhea (CID) among patients with colorectal cancer receiving multi-cycle chemotherapy |
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