Gastrointestinal toxicity and Clostridium difficile diarrhea in patients treated with paclitaxel-containing chemotherapy regimens Journal Article


Authors: Husain, A.; Aptaker, L.; Spriggs, D. R.; Barakat, R. R.
Article Title: Gastrointestinal toxicity and Clostridium difficile diarrhea in patients treated with paclitaxel-containing chemotherapy regimens
Abstract: Objective. The objective of this study was to determine the incidence of grade 3 and 4 gastrointestinal toxicity and the prevalence of Clostridium difficile-associated diarrhea (CDAD) in patients with gynecologic malignancies treated with paclitaxel-based chemotherapy regimens. Methods. We retrospectively reviewed the medical records of all patients treated on the Gynecology Service at Memorial SloanKettering Cancer Center from January 1, 1993 to July 1, 1996. We identified all patients treated with paclitaxel during this period and determined the total number of patients hospitalized for symptoms of gastrointestinal toxicity, including nausea, vomiting, diarrhea, and dehydration, within 4 weeks of chemotherapy, as well as the incidence of CDAD among these patients. Results. Six hundred and twenty-four patients were treated with paclitaxel-containing chemotherapy regimens during the study period, including 55 patients who were treated on a 'dose-dense' high-dose protocol for advanced ovarian cancer. Among these, 149 patients (24%) were hospitalized for symptoms of gastrointestinal toxicity. During the study period, a total of 40 cases of CDAD were reported among hospitalized patients on the Gynecology Service and 24 (60%) of these cases occurred in patients who had received paclitaxel within the prior 4 weeks. Conclusions. The occurrence of CDAD in patients receiving paclitaxel-containing chemotherapy is not rare and can result in severe dehydration requiring hospitalization. The risk of C. difficile colitis appears to be 2.2% in patients receiving standard-dose regimens and as high as 20% in patients receiving high-dose regimens. This etiology should be considered and treated early in patients presenting with symptoms of gastrointestinal toxicity subsequent to chemotherapy treatments.
Keywords: adult; cancer chemotherapy; aged; middle aged; retrospective studies; major clinical study; diarrhea; paclitaxel; nausea; vomiting; dehydration; prevalence; drug effect; retrospective study; genital neoplasms, female; gastrointestinal toxicity; anti-bacterial agents; clostridium difficile; gynecologic cancer; gastrointestinal diseases; clostridium infections; humans; human; female; priority journal; article; colon flora
Journal Title: Gynecologic Oncology
Volume: 71
Issue: 1
ISSN: 10956859
Publisher: Elsevier B.V.  
Date Published: 1998-10-01
Start Page: 104
End Page: 107
Language: English
DOI: 10.1006/gyno.1998.5158
PUBMED: 9784328
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 12 December 2016 -- Source: Scopus
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  1. Richard R Barakat
    629 Barakat
  2. David R Spriggs
    325 Spriggs
  3. Amreen   Husain
    19 Husain