Gastro-Intestinal
Chemotherapy Related Injury
Chemotherapy is far less likely than radiation therapy (RT) to cause chronic GI problems.
Multiple chemotherapy agents are responsible for acute GI toxicity (mucositis is most common), but these side effects resolve at the end of therapy.
Anthracyclines enhance the toxicity of RT and increase the risk of long term scarring and damage from RT.
Chemotherapy induced tumor lysis syndrome (when tumor involves gut) has been associated with GI perforation and fistula formation.
Second cancers:
Chemotherapy that included alkylating agents (e.g. cyclophosphamide) increases the risk of secondary CRC (colo-rectal cancer) in addition to radiation therapy.
Reference:
Secondary Colorectal Carcinoma After Childhood Cancer
Kerri Nottage, Joshua McFarlane, Matthew J. Krasin, Chenghong Li, Deokumar Srivastava, Leslie L. Robison and Melissa M. Hudson
This study showed that alkylating agent exposure was associated with an 8.8X increased risk of secondary CRC.
