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Distinct diarrhea profiles during outpatient chemotherapy

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Abstract

Purpose

Chemotherapy-induced diarrhea (CID) is a common symptom that occurs in 50 to 80% of patients. Given that the majority of the data on the occurrence and severity of CID is based on physician-rated toxicity criteria, this study’s purposes were to identify subgroups of patients with distinct CID profiles and determine how these subgroups differ in terms of demographic and clinical characteristics; severity, frequency, and distress of CID; the co-occurrence of common GI symptoms; and QOL.

Methods

Patients (n = 1133) completed the Memorial Symptom Assessment Scale six times over two cycles of chemotherapy. Latent profile analysis was used to identify subgroups of patients with distinct diarrhea profiles. Differences among these subgroups were evaluated using parametric and nonparametric statistics.

Results

Four distinct diarrhea profiles were identified: none (58.3%), decreasing (22.0%), increasing (5.2%), and high (14.5%). Compared with the none class, patients in the high class had a lower functional status, a worse comorbidity profile, were more likely to have gastrointestinal cancer, and were more likely to receive chemotherapy on a 14-day cycle. No differences were found among the classes in the percentages of patients who received chemotherapy with a targeted therapy.

Conclusion

Given that CID occurred in over 40% of the patients, clinicians should assess for this symptom and other common GI symptoms and initiate appropriate pharmacologic and dietary interventions.

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Data availability

Data will be provided to the publisher after they obtain a material transfer agreement from the University of California, San Francisco.

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Funding

This study was funded by a grant from the National Cancer Institute (CA134900). Dr. Miaskowski is an American Cancer Society Clinical Research Professor.

Author information

Authors and Affiliations

  1. School of Nursing, University of California, San Francisco, CA, USA

    Rafael Diaz, Kord M. Kober, Carol Viele, Bruce A. Cooper, Steven M. Paul & Christine Miaskowski

  2. Dana Farber Cancer Center, Boston, MA, USA

    Marilyn Hammer

  3. Rory Meyers College of Nursing, New York University, New York, NY, USA

    Fay Wright

  4. School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA

    Yvette P. Conley

  5. School of Medicine, University of California, San Francisco, CA, USA

    Jon D. Levine

  6. Department of Physiological Nursing, University of California, 2 Koret Way – N631Y, San Francisco, CA, 94143-0610, USA

    Christine Miaskowski

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  1. Rafael Diaz
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Contributions

All of the authors participated in the revisions to this paper and the interpretation of the results and approved the final paper.

Corresponding author

Correspondence to Christine Miaskowski.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethics approval

This study was approved by the Committee on Human Research at the University of California and the Institutional Review Boards at each of the study sites.

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Written informed consent was obtained from all of the patients.

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All of the authors read the final version of the paper and approved its submission for publication.

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Diaz, R., Kober, K.M., Viele, C. et al. Distinct diarrhea profiles during outpatient chemotherapy. Support Care Cancer 29, 2363–2373 (2021). https://doi.org/10.1007/s00520-020-05753-x

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  • DOI: https://doi.org/10.1007/s00520-020-05753-x

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