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  • Title: Management of cancer treatment-related diarrhea. Issues and therapeutic strategies.
    Author: Kornblau S, Benson AB, Catalano R, Champlin RE, Engelking C, Field M, Ippoliti C, Lazarus HM, Mitchell E, Rubin J, Stiff PJ, Vokes E, Wadler S.
    Journal: J Pain Symptom Manage; 2000 Feb; 19(2):118-29. PubMed ID: 10699539.
    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.
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