Feasibility of Chemotherapy in Patients with Inflammatory Bowel Disease-Related Gastrointestinal Cancer.

BACKGROUND/AIMS Long-standing inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn disease (CD), is a known risk factor for gastrointestinal (GI) cancer, especially colorectal cancer (CRC). However, the feasibility of chemotherapy for IBD-related GI cancer is not well understood in terms of efficacy and adverse events, because there are fewer GI cancer patients with IBD than without IBD. METHODOLOGY We retrospectively analyzed the medical records of eight IBD patients (CD = 5 and UC = 3) who received chemotherapy for IBD-related GI cancer between April 2003 and March 2013. RESULTS The most common gastrointestinal adverse event was diarrhea (75%); 38% of patients experienced grade 3 diarrhea. Moreover, all grade 3 diarrhea occurred in patients with CD. The most common hematologic adverse events were anemia (75%), leukopenia (38%), and neutropenia (30%); 25% of patients experienced grade 3 neutropenia. The other severe adverse events were grade 3 AST and ALT elevation (13%). CONCLUSIONS In this study, the incidence of grade 3 diarrhea was higher in patients with CD. The length and dysfunction of the small intestine is the most likely reason that diarrhea occurred more frequently in patients with CD.