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Near fatal 5-FU gut toxicity post surgery--remarkable effect of high-dose sucralfate.
J Chemother 2015; 27(3):188-92JC

Abstract

BACKGROUND

The objective of this review article and case report was to investigate the effectiveness of high-dose sucralfate on severe life-threatening 5-fluorouracil (5-FU) gut toxicity, with reference to, but not limited to dihydropyrimidine dehydrogenase (DPD) deficiency.

METHODS

A search was conducted on PubMed from 1950 to July 2013 for original studies on 5-FU gut toxicity and sucralfate. Studies were limited to human trials and English language and all articles included in this study were assessed with the application of predetermined selection criteria. Each article was then reviewed independently by two reviewers. A case report from our own centre was included in this review.

RESULTS

From 33 results, 6 manuscripts were identified including 4 randomized controlled trial. One trial evaluated the use of sucralfate to alleviate stomatitis in patients with 5-FU-based chemotherapy. The other three trials evaluated the role of sucralfate in radiation toxicity. There was one case report which showed gastroscopy confirmed normalization of severe dysplastic erosive gastroduodenitis attributed to hepatic arterial infusion of 5-FU following a 2-month course of sucralfate and cimetidine and one case series showing clinical and sigmoidoscopically demonstrated improvement in ulcerative colitis in majority of patients receiving sucralfate enemas. There was no current literature specifically focussed on the role of sucralfate in 5-FU gut toxicity. Our case report describes the clinical course and successful treatment with sucralfate of a patient with Pseudomyxoma peritonei (PMP) who experienced 5-FU gut toxicity resulting in life-threatening bleeding due to presumed DPD deficiency post intraperitoneal 5-FU administration.

CONCLUSION

This review article showed a lack of literature concerning the use of sucralfate in 5-FU gut toxicity. In our patient's case, sucralfate had a crucial role in the management of near fatal 5-FU gut toxicity, and further evaluation is required.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24571246

Citation

Toh, James Wei Tatt, et al. "Near Fatal 5-FU Gut Toxicity Post Surgery--remarkable Effect of High-dose Sucralfate." Journal of Chemotherapy (Florence, Italy), vol. 27, no. 3, 2015, pp. 188-92.
Toh JW, Morris D, Chen Z, et al. Near fatal 5-FU gut toxicity post surgery--remarkable effect of high-dose sucralfate. J Chemother. 2015;27(3):188-92.
Toh, J. W., Morris, D., Chen, Z., & Chen, C. (2015). Near fatal 5-FU gut toxicity post surgery--remarkable effect of high-dose sucralfate. Journal of Chemotherapy (Florence, Italy), 27(3), pp. 188-92. doi:10.1179/1973947814Y.0000000178.
Toh JW, et al. Near Fatal 5-FU Gut Toxicity Post Surgery--remarkable Effect of High-dose Sucralfate. J Chemother. 2015;27(3):188-92. PubMed PMID: 24571246.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Near fatal 5-FU gut toxicity post surgery--remarkable effect of high-dose sucralfate. AU - Toh,James Wei Tatt, AU - Morris,David, AU - Chen,Zhuoran, AU - Chen,Cindy, Y1 - 2014/02/27/ PY - 2014/2/28/entrez PY - 2014/2/28/pubmed PY - 2016/3/16/medline KW - 5-FU, KW - 5-fluorouracil, KW - Cancer KW - Chemotherapy, KW - DMD deficiency, KW - Peritonectomy, KW - Sucralfate, KW - Toxicity, SP - 188 EP - 92 JF - Journal of chemotherapy (Florence, Italy) JO - J Chemother VL - 27 IS - 3 N2 - BACKGROUND: The objective of this review article and case report was to investigate the effectiveness of high-dose sucralfate on severe life-threatening 5-fluorouracil (5-FU) gut toxicity, with reference to, but not limited to dihydropyrimidine dehydrogenase (DPD) deficiency. METHODS: A search was conducted on PubMed from 1950 to July 2013 for original studies on 5-FU gut toxicity and sucralfate. Studies were limited to human trials and English language and all articles included in this study were assessed with the application of predetermined selection criteria. Each article was then reviewed independently by two reviewers. A case report from our own centre was included in this review. RESULTS: From 33 results, 6 manuscripts were identified including 4 randomized controlled trial. One trial evaluated the use of sucralfate to alleviate stomatitis in patients with 5-FU-based chemotherapy. The other three trials evaluated the role of sucralfate in radiation toxicity. There was one case report which showed gastroscopy confirmed normalization of severe dysplastic erosive gastroduodenitis attributed to hepatic arterial infusion of 5-FU following a 2-month course of sucralfate and cimetidine and one case series showing clinical and sigmoidoscopically demonstrated improvement in ulcerative colitis in majority of patients receiving sucralfate enemas. There was no current literature specifically focussed on the role of sucralfate in 5-FU gut toxicity. Our case report describes the clinical course and successful treatment with sucralfate of a patient with Pseudomyxoma peritonei (PMP) who experienced 5-FU gut toxicity resulting in life-threatening bleeding due to presumed DPD deficiency post intraperitoneal 5-FU administration. CONCLUSION: This review article showed a lack of literature concerning the use of sucralfate in 5-FU gut toxicity. In our patient's case, sucralfate had a crucial role in the management of near fatal 5-FU gut toxicity, and further evaluation is required. SN - 1973-9478 UR - https://www.unboundmedicine.com/medline/citation/24571246/Near_fatal_5_FU_gut_toxicity_post_surgery__remarkable_effect_of_high_dose_sucralfate_ L2 - http://www.tandfonline.com/doi/full/10.1179/1973947814Y.0000000178 DB - PRIME DP - Unbound Medicine ER -