Gastroparesis as a significant gastrointestinal adverse event during intensive chemotherapy for solid caner: a case...

Proper management of chemotherapy-related gastrointestinal toxicities is essential to maximize therapeutic outcome for malignancies. Gastroparesis is an onerous syndrome characterized by delayed gastric emptying without gastrointestinal obstruction, but this has not been recognized as chemotherapy-related complication in solid malignancies. Here, we describe a case of gastroparesis possibly caused by neurotoxicity of taxane and platinum-based high-intensity chemotherapy against solid cancer.

A 73-year-old male was diagnosed with stage IVA oropharyngeal cancer (cT4N2bM0) as a cause of swallowing difficulty. As a curative treatment of the oropharyngeal cancer, induction chemotherapy with the regimen of docetaxel, cisplatin and fluorouracil (TPF) was initiated with nutritional support by nasogastric tube feeding. Then, this case was complicated with late-onset gastric dysmotility as evidenced by abnormally dilated stomach even after cessation of feeding for more than a few days. After a careful exclusion of other diseases that could cause gastric dysmotility, we eventually diagnosed chemotherapy-induced gastroparesis as a cause of his symptom. Notably, this refractory gastroparesis was successfully controlled with 5-HT4 agonist, mosapride, resulting in recovery of gastric motility and safe completion of the subsequent curative treatment.

Despite its rarity in patients with solid cancers, it is important to note chemotherapy-induced gastroparesis because delay in its management can be detrimental to their survival outcome. Thus, oncologists should consider gastroparesis in evaluating persistent upper abdominal symptoms after neurotoxic chemotherapies for solid cancer.