Prevention of irinotecan associated diarrhea by intestinal alkalization. A pilot study in gastrointestinal cancer patients

RESUMEN

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ABSTRACT

Aim and background. Intestinal alkalization couldprevent irinotecan associated diarrhea modulatingsome chemical equilibria between irinotecan metabolites.The aim of this study was to evaluate the efficacyof this procedure in advanced gastrointestinalcancer patients (GICP).Materials and method. In this prospective studyadvanced GICP, receiving irinotecan based chemotherapyregimens, were well trained to add sodiumbicarbonate to the water intake in order to accomplishintestinal alkalization.Results. A total of twenty four advanced GICP wereenrolled. Grade III-IV diarrhea has been observedin four patients (16%), some of whom had severalrisk factors for diarrhea. Only one out of seventeencolorectal cancer patients, receiving the irinotecancombination as first line therapy, had grade III-IVdiarrhea. No side effects of the procedure have beenappreciated.Conclusions. Intestinal alkalization may be effectiveas a preventive treatment for irinotecan associateddiarrhea in chemotherapy regimens used in GICP.This procedure deserves further investigation