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High risk for chemotherapy-induced diarrhea in patients with colorectal cancer
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Chemotherapy-induced diarrhea occurred frequently in patients undergoing treatment for colorectal cancer, especially during first exposure, which significantly affected quality of life, according to recent study data.
“These … data clearly show that diarrhea occurs more commonly than is typically reported in the literature during chemotherapy for colorectal cancer (CRC),” the researchers wrote.
As part of the multinational prospective TRIAD Burden of Illness Study, researchers evaluated patients with colorectal cancer undergoing standard chemotherapy to better understand the risk factors and burden associated with chemotherapy-induced diarrhea (CID).
Patients received either FOLFOX (n=95; 530 cycles), FOLFOX plus monoclonal antibodies (n=10; 49 cycles) or FOLFIRI (n=9; 50 cycles). They graded CID severity on a 10-point scale and frequency on a 5-point scale in diaries using questions from the Oral Mucositis Daily Questionnaire through up to eight treatment cycles. Quality of life (QOL) was evaluated by the Functional Assessment of Cancer Therapy instrument; fatigue was assessed by the Functional Assessment of Chronic Illness Therapy scale.
CID occurred in 89% of the FOLFIRI group, 56% of the FOLFOX group and 50% of the FOLFOX plus monoclonal antibodies group. Risk for CID was highest during the first cycle of chemotherapy (35%), dropping below 10% for cycles three through five. Compared with those in whom CID did not occur, patients with CID reported lower mean QOL scores (77.1 vs. 80.7).
“The risk of CID is highest during the first exposure to chemotherapy, suggesting that some patients are more susceptible than others, and those patients at high risk may drop out of treatment earlier,” the researchers concluded. “Identification of those patients at high risk for CID would enable prophylactic treatment that may reduce the incidence and severity of CID and could improve [QOL] among this high-risk group.”
Disclosure: The researchers report no relevant financial disclosures.
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