[Chemotherapy and NSAIDs in neoplastic disease. Role of anti-secretory preventive therapy].
The patients treated by chemotherapy should be considered at high-risk for developing serious lesions of upper gastrointestinal tract. Several factors should be considered during the initial management of these patients, such as the presence and the staging of the malignancy, the cytotoxic effects of the antiblastic drugs, the co-administration of NSAIDs and corticosteroids, and the possible co-existence of Helicobacter pylori infection, hiatal hernia, and gastro-esophageal reflux. In order to prevent gastro-duodenal damage, the optimal approach first has to include an accurate clinical and pharmacological evaluation. The upper gastrointestinal endoscopy should also be performed in neoplastic patients undergoing chemotherapy before starting treatment. Proton pump inhibitors can play a major role in these patients to prevent gastro-duodenal damages, and to relieve dyspeptic symptoms.
Annibale
Bruno
B
Cattedra di Gastroenterologia, II Facoltà di Medicina e Chirurgia, Università La Sapienza, Divisione di Malattie Digestive e del Fegato, Azienda Ospedaliera Sant'Andrea, Roma. bruno.annibale@uniroma1.it
Panzuto
Francesco
F
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects; D004198:Disease Susceptibility; D004311:Double-Blind Method; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D010437:Peptic Ulcer / Q000139:chemically induced / Q000382:microbiology / Q000517:prevention & control*; D054328:Proton Pump Inhibitors; D016032:Randomized Controlled Trials as Topic
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D000970:Antineoplastic Agents; D016861:Cyclooxygenase Inhibitors; D004791:Enzyme Inhibitors; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors