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. 2020 Mar 4;11(11):3144-3150.
doi: 10.7150/jca.37777. eCollection 2020.

Gastrointestinal toxic effects in patients with cancer receiving platinum-based therapy

Hamzah Abu-Sbeih  1 , Niharika Mallepally  2 , Ryan Goldstein  3 , Ellie Chen  2 , Tenglong Tang  1 , Uzoamaka K Dike  3 , Mazen Al-Asadi  1 , Shannon Westin  4 , Daniel Halperin  5 , Yinghong Wang  1
Affiliations

Gastrointestinal toxic effects in patients with cancer receiving platinum-based therapy

Hamzah Abu-Sbeih et al. J Cancer. .

Abstract

Background: Platinum-based therapy (PBT) can be limited by gastrointestinal adverse events, particularly PBT-related colitis and diarrhea (PCD). We studied clinical features, treatments, and outcomes of PCD. Methods: This was a retrospective study of cancer patients who received PBT and colonoscopic evaluation for PCD symptoms from 2009 to 2018. Results: Of 36,595 patients who received PBT, 86 (0.2%) met inclusion criteria. Median time from PBT initiation to PCD was 66 days. Regarding PBT type, 47% of the patients received carboplatin, 31% cisplatin, and 22% oxaliplatin. Median duration of PCD symptoms was 20 days. Colonoscopy revealed mucosal ulceration in 34% of the patients and nonulcerative inflammation in 33%. Half of the cohort needed hospitalization for PCD (49%). The majority received treatment for PCD (59%): immunosuppressive therapy in 21%, antibiotics in 27%, antimotility agents in 22%, and intravenous fluids in 51%. Eight patients (9%) were admitted to the intensive care unit for PCD management. Six patients (7%) experienced colonic perforation that required surgical intervention; two of them had gastrointestinal tumors. Physicians restarted PBT in 37 (43%) patients; 8 (22%) of them had PCD recurrence that was managed expectantly. Colonic perforation occurred more frequently with use of oxaliplatin and cisplatin than carboplatin (P=0.05). The median duration of PCD symptoms was longer in patients receiving carboplatin or cisplatin than in those receiving oxaliplatin (P=0.182). Conclusions: PCD is rare, but in a small subset of patients, it can lead to serious complications. Treatment of PCD is mainly supportive, but immunosuppressive therapy may be required.

Keywords: carboplatin; cisplatin; colitis; gastrointestinal toxicity; platinum.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Flowchart of the study patients.
Figure 2
Figure 2
Endoscopy presentation of platinum-related colitis. Superficial ulcers (left); and diffuse erythema and edema (right).
See this image and copyright information in PMC

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