Prévalence de la Toxicité Gastro-Intestinale chez les Patients Recevant une Chimiothérapie à Base de Platine à l'Hôpital Général de Douala
Prevalence of Gastrointestinal Toxicity in Patients Receiving Platinum-Based Chemotherapy at Douala General Hospital
DOI :
https://doi.org/10.5281/hra.v2i5.5654Mots-clés :
Platins, chemotherapy, prevalence, gastrointestinal, toxicityRésumé
ABSTRACT
Background. The purpose of this study was to determine the prevalence of gastrointestinal toxicity in platinum-based chemotherapy and assess factors associated to it in Douala General Hospital. Methodology. It was a hospital based descriptive and analytic study carried out in 4 months from January to April 2017. Convenience sampling was used, demographic data and of the occurrence of gastrointestinal toxicity was investigated in patients on any platinum-based chemotherapeutic regimen. Results: Out of 100 patients studied, 74% were females and 26% were males with a mean age of 48.9 years. The prevalence of platinum-based chemotherapy induced gastrointestinal toxicity was 91%. The most frequent clinical manifestations were anorexia (79%), nausea/vomiting (73%), taste change (54%), diarrhoea (46%), bloating (23%), constipation (21%), belching (20%) flatulence (20%) and mucositis (18%). Most patients (97.4%) had less than grade 3 toxicity severity for clinical manifestations in general and only nausea/vomiting (1%) and diarrhoea (4%) were life threatening (grade 4 severity). Cisplatin was found to be more emetogenic and to cause more anorexia than the other platins while carboplatin was found to cause more rectal burning. Being at least 40 years old, being on chemotherapy alone compared with concurrent chemoradiation, being on a cisplatinum-based regimen and having received at least 3 cycles of chemotherapy were significantly associated with the occurrence of GI toxicities. Conclusion. Gastrointestinal toxicity following platinum-based chemotherapy is very common with many clinical manifestations that can be life threatening. Toxicity is associated to clinical factors. A more in-depth study is recommended.
RÉSUMÉ
Contexte. L'objectif de cette étude était de déterminer la prévalence de la toxicité gastro-intestinale de la chimiothérapie à base de platine et d'évaluer les facteurs qui y sont associés à l'hôpital général de Douala. Méthodologie. Il s'agissait d'une étude descriptive et analytique en milieu hospitalier réalisée en 4 mois de janvier à avril 2017. L'échantillonnage de convenance a été utilisé, les données démographiques et de la survenue de la toxicité gastro-intestinale ont été recherchées chez les patients sous tout régime chimiothérapeutique à base de platine. Résultats : Sur les 100 patients étudiés, 74% étaient des femmes et 26% des hommes avec un âge moyen de 48,9 ans. La prévalence de la toxicité gastro-intestinale induite par la chimiothérapie à base de platine était de 91 %. Les manifestations cliniques les plus fréquentes étaient l'anorexie (79%), les nausées/vomissements (73%), le changement de goût (54%), la diarrhée (46%), les ballonnements (23%), la constipation (21%), les éructations (20%), les flatulences (20%) et la mucosite (18%). La plupart des patients (97,4 %) ont présenté des manifestations cliniques d'une gravité inférieure au grade 3 et seuls les nausées/vomissements (1 %) et la diarrhée (4 %) ont mis leur vie en danger (gravité de grade 4). Le cisplatine s'est avéré plus émétisant et plus anorexique que les autres platines, tandis que le carboplatine a provoqué davantage de brûlures rectales. Le fait d'être âgé d'au moins 40 ans, d'être sous chimiothérapie seule par rapport à une chimioradiothérapie concomitante, d'être sous un régime à base de cisplatine et d'avoir reçu au moins 3 cycles de chimiothérapie était significativement associé à la survenue de toxicités gastro-intestinales. Conclusion. La toxicité gastro-intestinale après une chimiothérapie à base de platine est très fréquente et s'accompagne de nombreuses manifestations cliniques qui peuvent mettre en jeu le pronostic vital. La toxicité est associée à des facteurs cliniques. Une étude plus approfondie est recommandée.
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