title: Efficacy of prophylactic anti-diarrhoeal treatment in patients receiving Campto for advanced colorectal cancer.
abstract: This study assessed the efficacy of combined prophylactic and curative anti-diarrhoeal medication in advanced colorectal patients treated by irinotecan. Thirty-four pre-treated eligible patients were evaluated. There were 44% women, the median age was 65 and 38% of the patients had a 0 performance status. The patients received sucralfate(4g/d) and nifuroxazide(600 mg/d) prophylactic treatment on days 0-7. In the case of severe diarrhoea, preventive treatment was replaced by loperamide(12 mg/d) and diosmectite (9 g/d). Grade 3 delayed diarrhoea occurred in 18% of patients (90% CI: [9.5-28.9]) and 4.6% of cycles. No grade 4 delayed diarrhoea was observed. Twenty-nine patients (85%) received the preventive treatment at cycle 1, while 14% (90% CI: [6.2-25.7]) experienced grade 3 delayed diarrhoea in 3.7% of cycles for a median 4.5 days. The objective response rate was 8% (90% CI [1.4-23.1]) among the 25 assessable patients. Preventive combined treatment is effective in reducing the incidence of severe delayed diarrhoea, and it should be proposed to patients treated with mono-therapy Campto(r) and evaluated in poly-chemotherapy protocols.
authors.affiliation: Hopital La Timone, 264 rue St-Pierre, Marseille, France.
authors.forename: J
authors.initials: J
authors.lastname: Duffour
authors.forename: S
authors.initials: S
authors.lastname: Gourgou
authors.forename: J F
authors.initials: JF
authors.lastname: Seitz
authors.forename: P
authors.initials: P
authors.lastname: Senesse
authors.forename: O
authors.initials: O
authors.lastname: Boutet
authors.forename: D
authors.initials: D
authors.lastname: Castera
authors.forename: A
authors.initials: A
authors.lastname: Kramar
authors.forename: M
authors.initials: M
authors.lastname: Ychou
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D000930:Antidiarrheals / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects* / Q000627:therapeutic use; D002166:Camptothecin / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000150:complications / Q000188:drug therapy*; D003967:Diarrhea / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D062385:Hydroxybenzoates / Q000627:therapeutic use*; D000077146:Irinotecan; D008139:Loperamide / Q000627:therapeutic use; D008875:Middle Aged; D009581:Nitrofurans / Q000627:therapeutic use*; D017640:Silicates; D013392:Sucralfate / Q000627:therapeutic use*
chemical_list: D000890:Anti-Infective Agents; D000897:Anti-Ulcer Agents; D000930:Antidiarrheals; D000972:Antineoplastic Agents, Phytogenic; D005765:Gastrointestinal Agents; D062385:Hydroxybenzoates; D009581:Nitrofurans; D017640:Silicates; D013392:Sucralfate; D008139:Loperamide; D000077146:Irinotecan; C033214:Smectite; C013150:nifuroxazide; D002166:Camptothecin