misoprostol and Neoplasms

Alimentary mucositis is a significant complication of cancer therapy, with important clinical and economic implications.. In June 2005, the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology conducted an evidence-based review of the literature on alimentary mucositis. The goal of this literature review was to update previously published guidelines for the management of mucositis.. This article reports the findings of the subgroup charged with reviewing the literature related to anti-inflammatory interventions. Considerable preclinical and clinical evidence suggests that the use of anti-inflammatory agents may be a promising approach to reduce the severity of mucositis. However, there was not enough evidence to support any new guidelines advocating the use of any specific anti-inflammatory intervention.. Thus, there is a need for well-designed clinical trials evaluating the use of anti-inflammatory agents in the management of mucositis.

Topics: Allopurinol; Animals; Anti-Inflammatory Agents; Anti-Ulcer Agents; Antineoplastic Agents; Benzydamine; Clinical Trials as Topic; Drug Evaluation; Evidence-Based Medicine; Flurbiprofen; Gastrointestinal Diseases; Health Services Needs and Demand; Humans; Metalloproteins; Misoprostol; Mucositis; Neoplasms; Practice Guidelines as Topic; Radiation-Protective Agents; Radiotherapy; Research Design; Severity of Illness Index; Stomatitis; Triazines

Topics: Abortion, Induced; Animals; Cervix Uteri; Clinical Trials as Topic; Contraceptives, Postcoital; Endometriosis; Female; Humans; Hydrocortisone; Labor, Induced; Mifepristone; Misoprostol; Neoplasms; Pregnancy

From April 1993 to September 1993, 15 patients with lymphoid or solid neoplasms underwent 16 non-cryopreserved peripheral stem cell transplantation courses using the ICE (ifosfamide, carboplatin, etoposide) program. They were randomized in a double-blind clinical trial to received oral misoprostol or placebo for mucositis prophylaxis. The active drug or placebo administration began jointly with chemotherapy at day -4 and was continued until day 16. The mucositis incidence and severity was significantly higher in patients who received misoprostol. We found no differences regarding myelosuppression, infections or other chemotherapy complications. Our results do not support the use of oral misoprostol as administered in this study, for high-dose chemotherapy-induced mucositis prophylaxis.

Topics: Adolescent; Adult; Aged; Anti-Ulcer Agents; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Double-Blind Method; Etoposide; Female; Hematopoietic Stem Cell Transplantation; Humans; Ifosfamide; Male; Middle Aged; Misoprostol; Mouth Mucosa; Neoplasms; Stomatitis

The prophylactic strategy of nonsteroidal antiinflammatory drug (NSAID)-induced upper gastrointestinal (UGI) damage has largely been studied in arthritic patients, but not in cancer patients. The efficacy of misoprostol and ranitidine in the prevention of gastroduodenal damage in patients taking diclofenac for their cancer pain has been compared in this study.. Patients who needed high-dose (200 to 300 mg/d) diclofenac for cancer pain and without mucosal lesions at baseline gastroduodenal endoscopy were randomized to receive misoprostol (200 micrograms twice daily; M group) or ranitidine (150 mg twice daily; R group). UGI endoscopy was repeated after 4 weeks.. Twenty-three patients treated with misoprostol and 26 treated with ranitidine concluded the study. The M group showed a significantly (P < .02) lower incidence of gastroduodenal lesions (two patients; 8.7%) than the R group (10 patients; 38.5%). Gastric ulcers occurred in one (4%) misoprostol-treated patient and in six (23%) ranitidine-treated patients. Six of seven patients with ulcers were asymptomatic. Seventy-one percent and 86% of ulcers occurred in patients older than 60 years and in those who received greater than 3.1 mg/kg of diclofenac, respectively.. Misoprostol was significantly more effective than ranitidine in the prevention of gastroduodenal lesions in cancer patients receiving diclofenac.

Topics: Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Diclofenac; Duodenal Ulcer; Female; Humans; Male; Middle Aged; Misoprostol; Neoplasms; Odds Ratio; Pain; Ranitidine; Risk Factors; Single-Blind Method; Stomach Ulcer

Topics: Abortifacient Agents; Abortion, Induced; Female; Humans; Methotrexate; Mifepristone; Misoprostol; Neoplasms; Pregnancy