Substantial activity of budesonide in patients with irinotecan (CPT-11) and 5-fluorouracil induced diarrhea and failure of loperamide treatment.
| Autor: | Lenfers BH; Department of Medicine (Gastroenterology/Medical Oncology/Endocrinology), Staedtische Kliniken Dortmund, Germany. bekelenfers@t-online.de, Loeffler TM, Droege CM, Hausamen TU |
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| Jazyk: | angličtina |
| Zdroj: | Annals of oncology : official journal of the European Society for Medical Oncology [Ann Oncol] 1999 Oct; Vol. 10 (10), pp. 1251-3. |
| DOI: | 10.1023/a:1008390308416 |
| Abstrakt: | Background: Diarrhea is one of the most disturbing effects of chemotherapy, affecting quality of life on the one hand and limiting applicable doses on the other. Irinotecan (CPT-11) and 5-fluorouracil (5-FU) are associated with an elevated risk of developing severe diarrhea. Standard therapy consists of high-dose loperamide, but is associated with frequent failure. Other therapeutic regimens are still experimental. Endoscopic examination of a patient with severe loperamide-resistant diarrhea after CPT-11 chemotherapy revealed an inflammation of the ileo-coecal region. Oral therapy with the topical corticosteroid budesonide was immediately effective. This led to a phase I study of budesonide in CPT-11- and 5-FU-induced and loperamide-refractory diarrhea. Patients and Methods: Fourteen patients with CPT-11- and seven patients with 5-FU-induced grade 3-4 (NCI/WHO) diarrhea and loperamide failure were enrolled in this study. All patients had metastatic colorectal cancer. Results: In 86% of the CPT-11- and 57% of the 5-FU-treated patients with grade 3-4 diarrhea and loperamide failure, treatment with budesonide resulted in a reduction of diarrhea severity by at least two grades. Conclusions: The orally administered topical active steroid budesonide is highly effective in the therapy of loperamide-refractory chemotherapy (CPT-11 or 5-FU)-induced diarrhea. |
| Databáze: | MEDLINE |
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