Prevention of irinotecan associated diarrhea by intestinal alkalization. A pilot study in gastrointestinal cancer patients.
OBJECTIVE
Intestinal alkalization could prevent irinotecan associated diarrhea modulating some chemical equilibria between irinotecan metabolites. The aim of this study was to evaluate the efficacy of this procedure in advanced gastrointestinal cancer patients (GICP).


METHODS
In this prospective study advanced GICP, receiving irinotecan based chemotherapy regimens, were well trained to add sodium bicarbonate to the water intake in order to accomplish intestinal alkalization.


RESULTS
A total of twenty four advanced GICP were enrolled. Grade III-IV diarrhea has been observed in four patients (16%), some of whom had several risk factors for diarrhea. Only one out of seventeen colorectal cancer patients, receiving the irinotecan combination as first line therapy, had grade III-IV diarrhea. No side effects of the procedure have been appreciated.


CONCLUSIONS
Intestinal alkalization may be effective as a preventive treatment for irinotecan associated diarrhea in chemotherapy regimens used in GICP. This procedure deserves further investigation.
Valentí Moreno
Vicente
V
Medical Oncology Department, Hospital de Sant Joan, Reus, Spain. vvalenti@eresmas.com
Brunet Vidal
Joan
J
Manzano Alemany
Hermini
H
Salud Salvia
Antonia
A
Llobera Serentill
Montserrat
M
Cabezas Montero
Inés
I
Servitja Tormo
Sonia
S
Sopena Bert
Eugenia
E
Gumà Padró
Josep
J
D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D002166:Camptothecin / Q000009:adverse effects / Q000031:analogs & derivatives*; D003967:Diarrhea / Q000139:chemically induced* / Q000517:prevention & control*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D006801:Humans; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D017693:Sodium Bicarbonate / Q000627:therapeutic use*
D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D017693:Sodium Bicarbonate; D002166:Camptothecin