Which chemotherapeutic agent is known to cause ileus?

Vinca alkaloids, such as vincristine and vinblastine, are well-known for their tendency to cause gastrointestinal effects, including ileus. This side effect is primarily due to the neurotoxic nature of these agents, which can affect the function of the enteric nervous system. The enteric nervous system plays a crucial role in regulating gut motility, and its disruption can lead to decreased peristalsis and the development of ileus.

Ileus can present clinically with symptoms such as abdominal distension, nausea, and constipation. The mechanism involves both direct neural toxicity and indirect effects on the overall autonomic regulation of gut function, contributing to slowed gastrointestinal motility following chemotherapy administration.

The other options mentioned have different specific side effects or mechanisms of action that are less likely to result in ileus. For example, paclitaxel is more commonly associated with peripheral neuropathy and other systemic effects, cytarabine mainly causes myelosuppression, and doxorubicin is known for its cardiotoxic effects.