Activated charcoal to prevent irinotecan-induced diarrhea in children

We performed a prospective study to evaluate the efficacy of activated charcoal (AC) to prevent irinotecan-induced diarrhea (IID).

We designed a prospective trial including all patients receiving irinotecan as part of their chemotherapy treatment. Patients were divided into two groups. The experimental group received AC at a dose of 250 mg three times daily during irinotecan administration. The number and severity of events were graded according to the gastrointestinal toxicity criteria of the NCI Common Toxicity Criteria. We used descriptive statistics, Mann-Whitney U test, and Fisher's exact test to evaluate our results.

Twenty-two evaluable patients were included for a total of 66 irinotecan chemotherapy cycles. Ten patients received AC and 12 did not. There were 45 cycles in the experimental group and 21 in the control group. A total of 28 events of diarrhea were registered, 13 in 45 cycles (28.88%) in the experimental group and 15 in 21 cycles (71.42%) in the control group (P = 0.002). Grade 3 and 4 diarrhea was present in 4.4% of patients receiving AC against 52.3% in the controls (P = 0.010). Chemotherapy was discontinued in 6.6% in the experimental group and 52.3% in the control group.

The use of AC decreased the frequency and severity of IID improving compliance with treatment. We consider AC and effective and safe prophylactic treatment to prevent IID.