Chinese expert consensus on whole-process management of chemotherapy-related diarrhea (2025 edition)

Association Committee of Rehabilitation and Palliative Care China Anti-Cancer; Association Committee of Cancer Pain Fujian Anti-Cancer

doi:10.19401/j.cnki.1007-3639.2025.06.011

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Chinese expert consensus on whole-process management of chemotherapy-related diarrhea (2025 edition)

Guideline and Consensus | 更新时间：2025-12-31

- Chinese expert consensus on whole-process management of chemotherapy-related diarrhea (2025 edition)
- China Oncology Vol. 35, Issue 6, Pages: 605-630(2025)
- 作者机构：
- 作者简介：
- 基金信息：
  
  Fujian Provincial Science and Technology Innovation Joint Fund Project(2023Y9420);Clinical Study Project on Bispecific Antibodies for Solid Tumors(ECCO-KY-23003)
- DOI：10.19401/j.cnki.1007-3639.2025.06.011
  CLC： R730.53
- Received：10 March 2025，
  
  Revised：2025-03-27，
  
  Published：30 June 2025
- 稿件说明：
移动端阅览
Association Committee of Rehabilitation and Palliative Care China Anti-Cancer, Association Committee of Cancer Pain Fujian Anti-Cancer. Chinese expert consensus on whole-process management of chemotherapy-related diarrhea (2025 edition)[J]. China Oncology, 2025, 35(6): 605-630.
DOI：

Association Committee of Rehabilitation and Palliative Care China Anti-Cancer, Association Committee of Cancer Pain Fujian Anti-Cancer. Chinese expert consensus on whole-process management of chemotherapy-related diarrhea (2025 edition)[J]. China Oncology, 2025, 35(6): 605-630. DOI： 10.19401/j.cnki.1007-3639.2025.06.011.

摘要

化疗作为癌症治疗的重要手段，在肿瘤治疗领域扮演着关键角色。然而，化疗相关腹泻是令人困扰的不良反应，可导致化疗剂量降低、治疗延迟或中止、治疗方案改变，严重时可危及生命。5-氟尿嘧啶和伊立替康是导致化疗相关腹泻最常见的化疗药物，近年来随着三药联合化疗方案运用的增加，腹泻相关死亡病例也随之增加，这可能与中性粒细胞减少性小肠结肠炎有关。洛哌丁胺是治疗化疗相关腹泻的主要药物，但如何管理洛哌丁胺治疗无效的腹泻是临床最关注的问题。因此，本专家组基于国内外循证医学证据，结合临床实践经验，对化疗相关腹泻的定义、发病机制、分类、评估、诊断、干预和预防进行充分的评估与讨论，最终形成《化疗相关腹泻全程管理中国专家共识（2025年版）》，以便进一步规范对化疗相关腹泻的全程管理。本共识已在国际实践指南注册与透明化平台（Practice guideline REgistration for transPAREncy，PREPARE）上注册，注册编号为PREPARE-2024CN1246。

Abstract

Chemotherapy is a critical treatment modality for cancer

playing an essential role in oncology. However

chemotherapy-related diarrhea (CRD) remains a troubling adverse effect

often leading to reduced chemotherapy doses

treatment delays or discontinuation

and modifications to therapeutic plans. In severe cases

CRD can be life-threatening. 5-fluorouracil and irinotecan are the most common chemotherapy drugs that cause CRD. With the increase in the use of triplet combination chemotherapy regimens

diarrhea-related deaths have increased

which may be related to neutropenic enterocolitis. Loperamide is the main drug for the treatment of CRD. In clinical practice

management of diarrhea that is not responsive to loperamide is of utmost concern. Therefore

based on evidence-based medicine and clinical practice experience

the expert panel carried out a comprehensive assessment and discussion on the definition

pathogenesis

classification

evaluation

diagnosis

intervention

and prevention of CRD. Eventually

the Chinese Expert Consensus on Whole-process Management of Chemotherapy-Related Diarrhea (2025 Edition) was formulated to further standardize the whole-process management of chemotherapy-related diarrhea. The consensus has been registered on Practice guideline REgistration for transPAREncy (PREPARE) with the registration number PREPARE-2024CN1246.

关键词

Keywords

references

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