Effect of chemotherapy with 5-fluorouracil on intestinal permeability and absorption in patients with advanced colorectal cancer.

Abstract

5-Fluorouracil (5-FU), in association with leucovorin (LV), is the most used chemotherapy agent in the treatment of colorectal cancer. Response rate, as well as side-effect incidence, increases with the dose intensity of regimens that are used. The most common dose-limiting toxicity for 5-FU/LV modulation is diarrhea. To assess the modification of small intestinal function, we investigated the changes in intestinal permeability (IP) and intestinal absorption (IA) in 41 chemo-naive patients (21 men and 22 women; mean age, 61 +/- 9 years) with advanced colorectal cancer after treatment with the association of folinic acid and 5-FU. After chemotherapy administration, we found a marked increase in IP and a reduction in IA, measured as cellobiose-mannitol (CE-MA) ratio (p < 0.0001) and D-xylose absorption (p = 0.0001), respectively. Patients who experienced diarrhea have an increase in CE-MA ratio and a reduction in D-xylose absorption values, both statistically significant. Cellobiose-mannitol ratio and D-xylose absorption tests can be used for the assessment of toxic effect of 5-FU on mature intestinal epithelium and also for evaluating the role of cytoprotective agents.

• Authors: B Daniele, M Secondulfo, R De Vivo, S Pignata, L De Magistris, P Delrio, R Palaia, E Barletta, R Tambaro, R Carratù
• Journal: Journal of clinical gastroenterology (J Clin Gastroenterol) Vol. 32 Issue 3 Pg. 228-30 (Mar 2001) ISSN: 0192-0790 [Print] United States
• PMID: 11246350 (Publication Type: Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Fluorouracil

Topics

• Antimetabolites, Antineoplastic (pharmacology, therapeutic use)
• Colorectal Neoplasms (drug therapy, metabolism, pathology)
• Fluorouracil (pharmacology, therapeutic use)
• Humans
• Intestinal Absorption
• Neoplasm Staging
• Permeability