Skip to main content
SpringerLink
Log in
Book cover

Drug-Induced Injury to the Digestive System pp 187–199Cite as

Gastrointestinal Damage by Cancer Chemotherapy

  • Conference paper

  • 65 Accesses

Abstract

Injury to the gastrointestinal tract may occur with any number of chemotherapy drugs used for the treatment of malignant disease. Indeed, the dosage of antineoplastic drugs is limited by toxic effects not only on the lungs, kidneys, and bone marrow but also on the liver and gastrointestinal tract. Some gastrointestinal symptoms such nausea, vomiting, anorexia, abdominal pain, and diarrhea may be either the presenting features of the underlying malignancy, usually self-limiting adverse reactions to drugs, or in some cases manifestations of more severe chemotherapy-induced gastrointestinal toxicity. Anticancer drugs as a group are thought preferentially to attack rapidly dividing tissues, including the gastrointestinal mucosa: nevertheless, remarkable little attention has been directed to the gastrointestinal epithelium and to its function in man.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Andrews PLR, Rapeport WG, Sanger GJ (1988) Neuropharmacology of emesis induced by anti-cancer therapy. Trends in Pharmacol Sci 9: 334–341

    Article  CAS  Google Scholar 

  2. Ansfield FJ, Ramírez G (1978) The clinical results of 5-fluorouracil intrahepatic arterial infusion in 528 patients with metastatic cancer to the liver. Prog Clin Cancer 7: 201–206

    PubMed  CAS  Google Scholar 

  3. Bleyer WA (1978) The clinical pharmacology of methotrexate. Cancer 41: 36–51

    Article  PubMed  CAS  Google Scholar 

  4. Blum RH, Carter SK (1974) Adriamycin: a new anticancer drug with significant clinical activity. Ann Int Med 80: 249–259

    PubMed  CAS  Google Scholar 

  5. Borison HL, McCarthy LE (1983) Neuropharmacology of chemotherapy induced emesis. Drugs 2 (Suppl 1): 8–17

    Article  Google Scholar 

  6. Borison HL, Wang WC (1953) Physiology and pharmacology of vomiting. Pharmacol Rev 5: 193–230

    PubMed  CAS  Google Scholar 

  7. Bremer K on behalf of the Granisetron Study Group (1992) A single-blind comparative study with alizapride plus dexamethasone in the prophylaxis and control of emesis in patients receiving cytostatic therapy over a 5-day treatment period. Eur J Cancer 28: 1018–1022

    Article  Google Scholar 

  8. Brereton HD, Kent CH, Johnson RE (1979) Chemotherapy and radiation therapy for small cell cancer of the lung: a remedy for past therapeutic failure. In: Muggia F, Rozencweig M (eds) Lung cancer: progress in therapeutic research. Raven, New York

    Google Scholar 

  9. Chevallier B, on behalf of the Granisetron Study Group (1990) Efficacy and safety of granisetron compared with high-dose metoclopramide plus dexametha-sone in patients receiving high-dose cisplatin in a single-blind study. Eur J Cancer 26 (Suppl 1) : S 33–S 37

    Google Scholar 

  10. Chu DZJ, Shivshanker K, Stoehlien JR et al. (1983) Thrombocytopenia and gastrointestinal hemorrhage in the cancer patient: prevalance of unmarked lesions. Gastrointest Endosc 29: 269–272

    Article  PubMed  CAS  Google Scholar 

  11. Craft AW, Kay HZM, Lawson DN et al. (1977) Methotrexate-induced malabsorption in children with acute lymphoblastic leukemia. BMJ 2: 1511–1512

    Article  PubMed  CAS  Google Scholar 

  12. Cudmore MA, Silva J, Fekety R et al. (1982) Clostridium difficile colitis associates with cancer chemotherapy. Arch Intern Med 142: 333–335

    Article  PubMed  CAS  Google Scholar 

  13. Cunningham D, Turner A, Hawthorn et al. (1989) Ondasentron with and without dexamethasone to treat chemotherapy-induced emesis (editorial), Lancet i: 1323

    Article  Google Scholar 

  14. D’Acquisto RW, Tyson LB, Gralla RJ et al. (1986) The influence of a chronic high alcohol intake on chemotherapy-induced nausea and vomiting. Proc Am Soc Clin Oncol 5: 257

    Google Scholar 

  15. Dana BW, McDermott M, Everts E et al. (1987) A randomized trial of high dose bolus metoclopramide versus low-dose continuous infusion metoclopramide in the prevention of cisplatin induced emesis. Am J Clin Oncol 10: 253–256

    Article  PubMed  CAS  Google Scholar 

  16. Diehl V on behalf of the Granisetron Study Group (1992) Fractionated chemotherapy-granisetron or conventional antiemetics?. Eur J Cancer 28 A (Suppll): S 21–S 28

    Article  Google Scholar 

  17. Dilly S (1992) Are granisetron and ondasentron equivalent in the clinic? Eur J Cancer 28 A (Suppl 1) : S 32–S 35

    Google Scholar 

  18. Donaldson SS, Glick JM, Wilbur SR (1974) Adriamycin activating a recall phenomenon after radiation therapy. Ann Intern Med 81: 407–408

    PubMed  CAS  Google Scholar 

  19. Donaldson SS, Lenon RA (1979) Alteration of nutritional status: the impact of chemotherapy and radiation therapy. Cancer 43: 2036–2052

    Article  PubMed  CAS  Google Scholar 

  20. Dosik GM, Luna M, Valdivieso M et al. (1979) Necrotizing colitis in patients with cancer. Am J Med 67: 646–656

    Article  PubMed  CAS  Google Scholar 

  21. Durant JR (1984) The problem of nausea and vomiting in modern cancer chemotherapy. CA 34: 2–6

    PubMed  CAS  Google Scholar 

  22. Einhorn LE, Nagy C, Werner K et al. (1990) Ondasentron: a new antiemetic for patients receiving cisplatin chemotherapy. J Clin Oncol 8: 731–735

    PubMed  CAS  Google Scholar 

  23. Faloon WW (1970) Drug production of intestinal malabsorption. NY State J Med 70: 2189–2192

    CAS  Google Scholar 

  24. Fetting JH, Grochow LB, Folstein MF et al. (1982) The course of nausea and vomiting after high dose cyclophosphamide. Cancer Treat Rev 66: 1487–1493

    CAS  Google Scholar 

  25. Freeman HJ, Rabeneck L, Owen D (1981) Survival after necrotizing enterocolitis of leukemia treated with oral vancomycin. Gastroenterology 81: 791–794

    PubMed  CAS  Google Scholar 

  26. Freeman AJ, Cullen MH (1991) Advances in the management of cytotoxic drug-induced nausea and vomiting. J Clin Pharm Ther 16: 411–421

    Article  PubMed  CAS  Google Scholar 

  27. Gralla RJ, Tyson LB, Kriss MG et al. (1987) The management of chemotherapy induced nausea and vomiting. Med Clin North Am 71: 289–301

    PubMed  CAS  Google Scholar 

  28. Gralla RJ (1989) An outline of anti-emetic treatment. Eur J Cancer 25 (Suppl 1) : S 7–S 11

    Google Scholar 

  29. Greco FA, Brereton HD, Kent H et al. (1976) Adriamycin and enhanced radiation reaction in normal esophagus and skin. Ann Intern Med 85: 294–298

    PubMed  CAS  Google Scholar 

  30. Gwavava NJT, Pinkerton CR, Glasgow JFT et al. (1981) Small bowel enterocyte abnormalities caused by methotrexate treatment in acute lymphoblastic leukemia of childhood. J Clin Pathol 34: 790–795

    Article  PubMed  CAS  Google Scholar 

  31. Harris JG (1978) Nausea, vomiting and cancer treatment. CA 28: 194–201

    PubMed  CAS  Google Scholar 

  32. Hoagland AC, Morrow GR, Bennet JM et al. (1983) Oncologists views of cancer patient noncompliance. Am J Clin Oncol 6: 239–244

    Article  PubMed  CAS  Google Scholar 

  33. Hohn DC, Stagg RJ, Price DC et al. (1985) Avoidance of gastroduodenal toxicity in patients receiving hepatic arterial 5-fluoro-2’-deoxyuridine. J Clin Oncol 3 (N. 9): 1257–1260

    PubMed  CAS  Google Scholar 

  34. Holland JF, Scharlau C, Gailani S et al. (1973) Vincristine treatment of advanced cancer: a cooperative study of 392 cases. Can Res 33: 1258–1264

    CAS  Google Scholar 

  35. Kearsley JH, Williams AM, Fiumara AM (1989) Antiemetic superiority of lora-zepam over oxazepam and methylprednisolone as premedicants for patients receiving cisplatin-containing chemotherapy. Cancer 64: 1595–1599

    Article  PubMed  CAS  Google Scholar 

  36. Krakoff IH (1987) Cancer chemotherapeutic agents. CA 37: 93–105

    PubMed  CAS  Google Scholar 

  37. Kris MG, Tyson LB, Gralla RJ (1983) Extrapyramidal reactions with high-dose metoclopramide. N Engl J Med 309: 433

    PubMed  CAS  Google Scholar 

  38. Kris MG, Gralla RJ, Clark RA et al. (1985) Incidence, course, and severity of delayed nausea and vomiting following the administration of high-dose cisplatin. J Clin Oncol 3: 1379–1384

    PubMed  CAS  Google Scholar 

  39. Laszlo J (ed) (1983) Antiemetics and cancer chemotherapy. Williams and Wil-kins, Baltimore, pp. 1–5

    Google Scholar 

  40. Laszlo J, Lucas VS (1981) Emesis as a critical problem in chemotherapy. N Engl J Med 305: 148–149

    Article  Google Scholar 

  41. Lewis JH et al. (1986) Gastrointestinal Injury Due to Medicinal Agents. Am J Gastroenterol 9: 819–834

    Google Scholar 

  42. Lindley CM, Bernard S, Fields SM (1989) Incidence and duration of chemotherapy-induced nausea and vomiting in the outpatient oncology population. J Clin Oncol 7: 1142–1149

    PubMed  CAS  Google Scholar 

  43. Marty M (1989) Ondasentron in the prophylaxis of acute cisplatin induced nausea and vomiting. Eur J Cancer 25 (Suppl 1): S 41-S 45

    Google Scholar 

  44. Marty M on behalf of the Granisetron Study Group (1990) A comparative study of the use of granisetron, a selective 5HT-3 antagonist, versus a standard antiemetic regimen of chlorpromazine plus dexamethasone in the treatment of cytostatic-induced emesis. Eur J Cancer 26: S 28–S 33

    Google Scholar 

  45. Marty M, Pouillart P, Scholl S et al. (1990) Comparison of the 5-hydroxytryptamine 3 (serotonin) antagonist ondasentron (GR 38032F) with high-dose metoclopramide in the control of cisplatin-induced emesis. N Engl J Med 322: 816–821

    Article  PubMed  CAS  Google Scholar 

  46. Marty M, On behalf of the Granisetron Study Group (1992) A comparison of granisetron as a single agent with conventional combination antiemetic therapies in the treatment of cytostatic-induced emesis. Eur J Cancer 28 A (Suppl 1): S 12–S 16

    Google Scholar 

  47. Mavligit GM, Faintuch J, Levin B et al. (1987) Gastroduodenal mucosal injury during hepatic arterial infusion of chemotherapeutic agents. Gastroenterology 92: 566–569

    PubMed  CAS  Google Scholar 

  48. McDonald GB, Tirumali N (1984) Intestinal and liver toxicity of antineoplastic drugs. West J Med 140: 250–259

    PubMed  CAS  Google Scholar 

  49. Mitchell EP, Schein PS (1982) Gastrointestinal toxicity of chemotherapeutic agents. Semin Oncol 9: 52–644

    PubMed  CAS  Google Scholar 

  50. Morrow GR (1982) Prevalence and correlates of anticipatory nausea and vomiting in chemotherapy patients. J Natl Cancer Inst 68: 585–588

    PubMed  CAS  Google Scholar 

  51. Morrow GR (1987) Management of nausea in the cancer patient. In: Rosenthal S, Carignan JR, Smith BD (eds) Medical care of the cancer patient. Saunders, Philadelphia, pp. 381–388

    Google Scholar 

  52. Morrow GR (1989) Chemotherapy-Related Nausea and Vomiting: Etiology and Management. CA 39: 102–103

    Google Scholar 

  53. Navari RM (1989) Comparison of intermittent versus continuous infusion metoclopramide in control of acute nausea induced by cisplatin chemotherapy. J Clin Oncol 7: 943–946

    PubMed  CAS  Google Scholar 

  54. Olver IN, Simon RM, Aisner J (1986) Antiemetic studies: a methodological discussion. Cancer Treat Rep 70: 555–563

    PubMed  CAS  Google Scholar 

  55. Pendergrass K, Hainsworth J, Harvey W et al. (1990) Ondasentron (OND): more effective than metoclopramide (MCP) in the prevention of cispla-tin (DDP)-induced nausea (N) and vomiting (V). Proc Am Soc Clin Oncol 9: 319

    Google Scholar 

  56. Penta J, Poster D, Bruno S (1983) The pharmacologic treatment of nausea and vomiting caused by cancer chemotherapy: a review. In: Laszlo J (ed) Antiemetics and cancer chemotherapy. Williams and Wilkins, Baltimore, pp. 53–92

    Google Scholar 

  57. Philips RKS, Glazer G, Borriello SP (1981) Non-Clostridium difficile pseudomembranous colitis responding to both vancomycin and metronidazole. BMJ 283: 823

    Article  Google Scholar 

  58. Priostman TJ (1989) Clinical studies with ondasentron in the control of radiation induced emesis. Eur J Cancer 25 (Suppl 1): S 29–S 33

    Google Scholar 

  59. Riddell RH (1982) The gastrointestinal tract. In: Riddell RD (ed) Pathology of drug-induced and toxic disease. Churchill Livingstone, New York, pp. 515–605

    Google Scholar 

  60. Roila F, Tonato M, Basurto C et al. (1987) Anti-emetic activity of high-doses of metoclopramide alone in cisplatin treated cancer patients: a randomized double-blind trial of the Italian oncology group for clinical research. J Clin Oncol 5: 141–149

    PubMed  CAS  Google Scholar 

  61. Roila F, Boschetti E, Tonato M et al. (1991) Predictive factors of delayed emesis in cisplatin-treated patients and antiemetic activity and tolerability of metoclopramide or dexamethasone. Am J Clin Oncol 14: 238–242

    Article  PubMed  CAS  Google Scholar 

  62. Rosenthal S, Kaufman S (1975) Vincristine neurotoxocity. Ann Intern Med 80: 733–737

    Google Scholar 

  63. Sandler SG, Tobin W, Henderson ES (1969) Vincristine induced neuropathy: a clinical study of fifty leukemia patients. Neurology (Minneapolis) 19: 367–374

    CAS  Google Scholar 

  64. Schmoll HJ (1989) The role of ondasentron in the treatment of emesis induced by non-cisplatin-containing chemotherapy regimens. Eur J Cancer 25 (Suppl 1): S 35–S 39

    Google Scholar 

  65. Schoenfield LF, Lachin JM (1981) The Steering Committee. Chenodiol (cheno-deoxycholic acid) for dissolution of gallstones: The National Cooperative Gallstone Study. A controlled trial of efficacy and safety. Ann Intern Med 95: 257–282

    PubMed  CAS  Google Scholar 

  66. Shaw MT, Spector MH, Ladman AJ (1979) Effects of cancer, radiotherapy and cytotoxic drugs on intestinal structure and function. Cancer Treat Rev 6: 141–151

    Article  PubMed  CAS  Google Scholar 

  67. Sherlock P (ed) (1979) Effect of cancer treatment on nutrition and gastrointestinal function. Clin Bull 9: 136–145

    Google Scholar 

  68. Shike M, Gillin JS, Kemeny N et al. (1986) Severe gastroduodenal ulcerations complicating hepatic artery infusion chemotherapy for metastatic colon cancer. Am J Gastroenterol 81: 176–179

    PubMed  CAS  Google Scholar 

  69. Slavin RE, Dias MA, Sarai R (1979) Cytosine arabinoside induced gastrointestinal toxic alterations in sequential chemotherapeutic protocols. A clinic pathologic study of 33 patients. Cancer 42: 1747–1759

    Article  Google Scholar 

  70. Sledge GW (1990) Chemotherapy-induced nausea and vomiting. Curr Opin Oncol 2: 909–914

    Article  PubMed  Google Scholar 

  71. Sledge GW, Einhorn LH, Nagy C et al. (1990) Randomized trial of ondasentron (OND) and metoclopramide (MCP) as antiemetic therapy for cisplatin-based chemotherapy. Proc Am Soc Clin Oncol 9: 323

    Google Scholar 

  72. Smith DB, Newlands ES, Spruyt OW et al. (1990) Ondasentron (GR38032F) plus dexamethasone: effective anti-emetic prophylaxis for patients receiving cytotoxic chemotherapy. Br J Cancer 61: 323–324

    Article  PubMed  CAS  Google Scholar 

  73. Smith IE on behalf of the Granisetron Study Group (1990) A comparison of two dose levels of granisetron in patients receiving moderately emetogenic cytostatic chemotherapy. Eur J Cancer 26 (Suppl 1): S 20–S 24

    Google Scholar 

  74. Smith FP, Kisner DL, Widerlite L et al. (1979) Chemotherapeutic alteration of small intestinal morphology and function: a progress report. J Clin Gastroenterol 1: 203–207

    Article  PubMed  CAS  Google Scholar 

  75. Soukop M on behalf of the Granisetron Study Group (1990) Comparison of two dose levels of granisetron in patients receiving high-dose cisplatin. Eur J Cancer 26 (Suppl 1) : S 16–S 20

    Google Scholar 

  76. Sullivan JR, Leyden MJ, Bell R (1983) Decreased cisplatin-induced nausea and vomiting with chronic alcohol ingestion. N Engl J Med 309: 796

    PubMed  CAS  Google Scholar 

  77. Trier JS (1962) Morphologic alterations induced by methotrexate in the mucosa of human proximal intestine. Gastroenterology 43: 407–424

    PubMed  CAS  Google Scholar 

  78. Tyers MB, Bunce KT, Humphrey PPA (1989) Pharmacological and anti-emetic properties of ondasentron. Eur J Cancer 25 (Suppl 1): S 15–S 19

    CAS  Google Scholar 

  79. Wagner ML, Rosenberg HS, Fernbach DJ et al. (1970) Typhlitis: a complication of leukemia in childhood. AJR 109: 341–350

    CAS  Google Scholar 

  80. Warrington PS, Allan SG, Cornbleet MA et al. (1988) Optimizing anti-emesis in cancer chemotherapy: efficacy of continuous versus intermittent infusion of high dose metoclopramide in emesis induced by cisplatin. BMJ 293: 1334–1337

    Article  Google Scholar 

  81. Weiss H, Walker M, Wiernik P (1974) Neurotoxicity of commonly used antineoplastic agents. N Engl J Med 291: 75–81, 127–133

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Digestive Endoscopy, Regional Cancer Center, Aviano, Italy

    M. Valentini, R. Cannizzaro, F. Bortoluzzi, M. Sozzi, M. Fornasarig & E. Bertolissi

Authors
  1. M. Valentini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Cannizzaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Bortoluzzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Sozzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Fornasarig
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Bertolissi
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Valentini, M., Cannizzaro, R., Bortoluzzi, F., Sozzi, M., Fornasarig, M., Bertolissi, E. (1993). Gastrointestinal Damage by Cancer Chemotherapy. In: Drug-Induced Injury to the Digestive System. Springer, Milano. https://doi.org/10.1007/978-88-470-2220-1_12

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2220-1_12

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2222-5

  • Online ISBN: 978-88-470-2220-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation