Chemotherapy-induced bowel ischemia: diagnostic imaging overview.
Adverse drug reactions
Bowel toxicity
Chemotherapy
Computed tomography
Journal
Abdominal radiology (New York)
ISSN: 2366-0058
Titre abrégé: Abdom Radiol (NY)
Pays: United States
ID NLM: 101674571
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
received:
06
11
2020
accepted:
25
02
2021
revised:
19
02
2021
pubmed:
4
4
2021
medline:
28
4
2022
entrez:
3
4
2021
Statut:
ppublish
Résumé
Cancer patients need multimodal therapies to treat their disease increasingly. In particular, drug treatment, as chemotherapy, immunotherapy, or various associations between them are commonly used to increase efficacy. However, the use of drugs predisposes a percentage of patients to develop toxicity in multiple organs and systems. Principle chemotherapy drugs mechanism of action is cell replication inhibition, rapidly proliferating cells especially. Immunotherapy is another tumor therapy strategy based on antitumor immunity activation trough agents as CTLA4 inhibitors (ipilimumab) or PD-1/PD-L1 inhibitors as nivolumab. If, on the one hand, all these agents inhibit tumor growth, on the other, they can cause various degrees toxicity in several organs, due to their specific mechanism of action. Particularly interesting are bowel toxicity, which can be clinically heterogeneous (pain, nausea, diarrhea, enterocolitis, pneumocolitis), up to severe consequences, such as ischemia, a rare occurrence. However, this event can occur both in vessels that supply intestine and in submucosa microvessels. We report drug-related intestinal vascular damage main characteristics, showing the radiological aspect of these alterations. Interpretation of imaging in oncologic patients has become progressively more complicated in the context of "target therapy" and thanks to the increasing number and types of therapies provided. Radiologists should know this variety of antiangiogenic treatments and immunotherapy regimens first because they can determine atypical features of tumor response and then also because of their eventual bowel toxicity.
Identifiants
pubmed: 33811514
doi: 10.1007/s00261-021-03024-9
pii: 10.1007/s00261-021-03024-9
pmc: PMC9038829
doi:
Substances chimiques
Antineoplastic Agents
0
Immune Checkpoint Inhibitors
0
Nivolumab
31YO63LBSN
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1556-1564Informations de copyright
© 2021. The Author(s).
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