Cancer therapy-induced intestinal injury: Mechanisms, clinical manifestations, and management strategies

Table 2 Therapeutic drugs/measures for intestinal injury caused by different kinds of cancer treatments

Treatment category	Drugs/measures	Mechanism	Clinical evidence level	Ref.
Symptomatic treatment	Loperamide, octreotide	Relieves symptoms by regulating intestinal activity and secretions	2	[67]
Immune modulation and immunotherapy	Corticosteroids, TNF-α antagonists, intravenous immunoglobulin, mycophenolate mofetil, methotrexate	Suppresses immune activation and reduces inflammation-related damage	2	[56-58]
Antioxidant and anti-inflammatory treatment	Glutathione, alpha-lipoic acid, TNF-α inhibitors, interleukin-6 inhibitors	Reduces oxidative stress and inflammation to protect intestinal cells	2-3	[4,60,61,68]
Stem cell and gut microbiota modulation	Glucagon-like peptide-2, probiotics, fecal microbiota transplantation, short-chain fatty acids	Enhances epithelial cell repair and restores gut microbiota balance	2-3	[62-65]
Emerging therapies	Mesenchymal stem cells, gene editing, nanoparticle drug delivery	Stimulates regeneration and promotes recovery through advanced techniques	4-5	[66]

Clinical evidence levels (1-5) in this table are assigned according to the 2011 Oxford Levels of Evidence (Centre for Evidence-Based Medicine, University of Oxford). Level 1 represents high-quality evidence derived from systematic reviews or randomized controlled trials; level 2 represents moderate-quality evidence from individual randomized controlled trials, cohort studies, or observational studies with dramatic effect; level 3 represents evidence from non-randomized controlled cohort or case-control studies; level 4 represents evidence from case series, poor-quality cohort/case-control studies, or historically controlled studies; level 5 represents expert opinion or mechanism-based reasoning. These levels reflect the reliability of clinical evidence supporting each intervention. TNF-α: Tumour necrosis factor-alpha.