title: Feasibility study of supportive care using lafutidine, a histamine H2 receptor antagonist, to prevent gastrointestinal toxicity during chemotherapy for gastric cancer.
abstract: The present study evaluated the efficacy of lafutidine, a histamine H2 receptor antagonist, for reducing gastrointestinal toxicities during adjuvant chemotherapy using oral fluorouracil anticancer drugs for gastric cancer.
  
  
  METHODS
  Patients with stage II (T1 cases excluded) or stage III gastric adenocarcinoma who underwent gastrectomy with D2 lymphadenectomy achieving R0 resection from 2011 to 2013 were prospectively enrolled in the study. Patients were randomly assigned to either S-1 treatment or S-1 plus lafutidine treatment. Quality of life and gastrointestinal toxicity were evaluated before chemotherapy and at 2, 4, and 6 weeks after the beginning of treatment.
  
  
  RESULTS
  The incidence of diarrhea during chemotherapy was significantly lower in the S-1 plus lafutidine group than in the group treated with S-1 alone (10% vs. 83%, respectively; p=0.002). The grades of diarrhea and nausea during chemotherapy were also significantly lower compared to those before chemotherapy in patients receiving S-1 plus lafutidine than in those administered S-1 alone. The rate of patients requiring a dose reduction or interruption of S-1 was significantly lower in the S-1 plus lafutidine group than in the group treated with S-1 alone (30% vs. 83%, respectively; p=0.027).
  
  
  CONCLUSIONS
  Lafutidine might be useful not only for preventing gastrointestinal toxicities during adjuvant chemotherapy for gastric cancer, but also for improving compliance with taking oral fluorouracil anticancer drugs. However, this indication needs to be confirmed in a larger, prospective, randomized, controlled trial.
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan tsutomun@kochi-u.ac.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Munekage
authors.affiliation: Cancer Treatment Center, Kochi Medical School, Kochi, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Maeda
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitagawa
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan.
authors.forename: Michiya
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Surgery, Kochi Medical School, Kochi, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
mesh_terms: D000081:Acetamides / Q000627:therapeutic use*; D000230:Adenocarcinoma / Q000188:drug therapy / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003967:Diarrhea / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*; D004338:Drug Combinations; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005743:Gastrectomy; D041981:Gastrointestinal Tract / Q000187:drug effects / Q000473:pathology; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*; D010094:Oxonic Acid / Q000009:adverse effects / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use*; D011446:Prospective Studies; D011725:Pyridines / Q000627:therapeutic use*; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005641:Tegafur / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000081:Acetamides; D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D006635:Histamine H2 Antagonists; D010880:Piperidines; D011725:Pyridines; C079198:S 1 (combination); D005641:Tegafur; C076948:lafutidine; D010094:Oxonic Acid; D005472:Fluorouracil
keywords: Chemotherapy; gastric cancer; gastrointestinal toxicity; histamine H2 receptor antagonist