Dranitsaris developed a score for identifying patients at risk for severe diarrhea following chemotherapy for advanced colorectal cancer. The authors are from the British Columbia Cancer Agency, the Humber River Regional Cancer Centre (Toronto) and the London Regional Cancer Program (Ontario) in Canada.
Patient selection: advanced colorectal cancer treated with FOLFOX or FOLFIRI chemotherapy (FO = 5-fluoruracil, LF = leukovorin, OX = oxaliplatin, IRI = irinotecan)
Parameters:
(1) ECOG performance score
(2) co-existing comorbidity (considered severe if not controlled by conventional therapy)
(3) serum total bilirubin
(4) primary tumor resected
(5) advanced locoregional spread
(6) distant metastases
(7) chemotherapy type
(8) time of year chemotherapy started
|
Parameter |
Finding |
Points |
|
ECOG performance scale |
0 to 2 |
0 |
|
|
3 or 4 |
4 |
|
co-existing |
none to moderate |
0 |
|
|
severe (uncontrolled) |
5 |
|
serum total bilirubin |
< 13 mg/dL |
0 |
|
|
>= 13 mg/dL |
1 |
|
primary tumor resected |
no |
0 |
|
|
yes |
2 |
|
advanced locoregional spread |
no |
0 |
|
|
yes |
3 |
|
distant metastases |
no |
0 |
|
|
yes |
2 |
|
chemotherapy |
with FOLFOX |
0 |
|
|
with FOLFIRI |
-1 |
|
time of year chemotherapy started |
summer months |
-3 |
|
|
other |
0 |
total score =
= SUM(points for all 8 parameters) + 4
Interpretation:
• minimum score: 0
• maximum score: 17
• The higher the score the greater the risk for chemotherapy-associated severe diarrhea.
|
Total Score |
Likelihood Ratio for Severe Diarrhea |
|
0 to 4 |
1 |
|
5 or 6 |
2 |
|
7 or 8 |
6 |
|
9 or higher |
145 |
Purpose: To identify a patient with colorectal cancer who is at risk for severe diarrhea following FOLFOX or FOLFIRI chemotherapy.
Specialty: Hematology Oncology, Gastroenterology, Pharmacology, clinical
Objective: severity, prognosis, stage, adverse effects
ICD-10: T45.1,
