Gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinum

<p>Abstract</p> <p>Background</p> <p>Combination of platinum derivatives with paclitaxel is currently the standard front line regimen for patients with epithelial ovarian carcinoma, and represents also an active regimen in patients with metastatic breast or unknown prim...

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Main Authors: Tichá Alena, Kalábová Hana, Dvořák Josef, Dragounová Emanuela, Hyšpler Radomír, Melichar Bohuslav
Format: Article
Language:English
Published: BMC 2007-08-01
Series:BMC Cancer
Online Access:http://www.biomedcentral.com/1471-2407/7/155
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author Tichá Alena
Kalábová Hana
Dvořák Josef
Dragounová Emanuela
Hyšpler Radomír
Melichar Bohuslav
author_facet Tichá Alena
Kalábová Hana
Dvořák Josef
Dragounová Emanuela
Hyšpler Radomír
Melichar Bohuslav
author_sort Tichá Alena
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Combination of platinum derivatives with paclitaxel is currently the standard front line regimen for patients with epithelial ovarian carcinoma, and represents also an active regimen in patients with metastatic breast or unknown primary carcinomas. Measurement of intestinal permeability represents one of the potential methods of noninvasive laboratory assessment of gastrointestinal mucositis induced by chemotherapy, but little is known about intestinal permeability in patients treated with paclitaxel or platinum.</p> <p>Methods</p> <p>Intestinal permeability was assessed in 36 breast and ovarian cancer patients treated with paclitaxel/platinum combination by measuring, using capillary gas chromatography, urinary sucrose, lactulose, xylose and mannitol after oral challenge. The significance of differences during the therapy compared to pre-treatment values was studied by Wilcoxon paired test. The differences between groups of patient were studied by Mann-Whitney U test. Fisher exact test was used to compare the frequency in different subgroups.</p> <p>Results</p> <p>After administration of the first dose, a significant (p < 0.05) decrease in xylose absorption and increased lactulose/mannitol, sucrose/mannitol, lactulose/xylose and sucrose/xylose ratios were observed, but these parameters returned subsequently to pre-treatment levels. Patients who experienced serious (grade 3 or 4) toxicity had at baseline significantly lower percentages of xylose, mannitol and sucrose, and higher lactulose/mannitol ratio. Nine of 13 (69%) patients with baseline lactulose/mannitol ratio 0.070 or above experienced serious toxicity compared to 4 out of 23 patients (17%) with the ratio below 0.070 (p = 0.002). Post-treatment lactulose, lactulose/mannitol, sucrose/mannitol and lactulose/xylose ratios were significantly increased in patients with serious toxicity.</p> <p>Conclusion</p> <p>A transient significant increase in lactulose/monosaccharide and sucrose/monosaccharide ratios was observed in ovarian and breast cancer patients treated with paclitaxel and platinum. Increased lactulose absorption, lactulose/mannitol, sucrose/mannitol and lactulose/xylose ratios were evident in patients with grade 3 or 4 toxicity, and increased baseline lactulose/mannitol ratio predicted serious toxicity.</p>
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spelling doaj.art-4de00bbc020043f481d226a48e342ae62022-12-22T01:02:23ZengBMCBMC Cancer1471-24072007-08-017115510.1186/1471-2407-7-155Gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinumTichá AlenaKalábová HanaDvořák JosefDragounová EmanuelaHyšpler RadomírMelichar Bohuslav<p>Abstract</p> <p>Background</p> <p>Combination of platinum derivatives with paclitaxel is currently the standard front line regimen for patients with epithelial ovarian carcinoma, and represents also an active regimen in patients with metastatic breast or unknown primary carcinomas. Measurement of intestinal permeability represents one of the potential methods of noninvasive laboratory assessment of gastrointestinal mucositis induced by chemotherapy, but little is known about intestinal permeability in patients treated with paclitaxel or platinum.</p> <p>Methods</p> <p>Intestinal permeability was assessed in 36 breast and ovarian cancer patients treated with paclitaxel/platinum combination by measuring, using capillary gas chromatography, urinary sucrose, lactulose, xylose and mannitol after oral challenge. The significance of differences during the therapy compared to pre-treatment values was studied by Wilcoxon paired test. The differences between groups of patient were studied by Mann-Whitney U test. Fisher exact test was used to compare the frequency in different subgroups.</p> <p>Results</p> <p>After administration of the first dose, a significant (p < 0.05) decrease in xylose absorption and increased lactulose/mannitol, sucrose/mannitol, lactulose/xylose and sucrose/xylose ratios were observed, but these parameters returned subsequently to pre-treatment levels. Patients who experienced serious (grade 3 or 4) toxicity had at baseline significantly lower percentages of xylose, mannitol and sucrose, and higher lactulose/mannitol ratio. Nine of 13 (69%) patients with baseline lactulose/mannitol ratio 0.070 or above experienced serious toxicity compared to 4 out of 23 patients (17%) with the ratio below 0.070 (p = 0.002). Post-treatment lactulose, lactulose/mannitol, sucrose/mannitol and lactulose/xylose ratios were significantly increased in patients with serious toxicity.</p> <p>Conclusion</p> <p>A transient significant increase in lactulose/monosaccharide and sucrose/monosaccharide ratios was observed in ovarian and breast cancer patients treated with paclitaxel and platinum. Increased lactulose absorption, lactulose/mannitol, sucrose/mannitol and lactulose/xylose ratios were evident in patients with grade 3 or 4 toxicity, and increased baseline lactulose/mannitol ratio predicted serious toxicity.</p>http://www.biomedcentral.com/1471-2407/7/155
spellingShingle Tichá Alena
Kalábová Hana
Dvořák Josef
Dragounová Emanuela
Hyšpler Radomír
Melichar Bohuslav
Gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinum
BMC Cancer
title Gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinum
title_full Gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinum
title_fullStr Gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinum
title_full_unstemmed Gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinum
title_short Gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinum
title_sort gastrointestinal permeability in ovarian cancer and breast cancer patients treated with paclitaxel and platinum
url http://www.biomedcentral.com/1471-2407/7/155
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AT dragounovaemanuela gastrointestinalpermeabilityinovariancancerandbreastcancerpatientstreatedwithpaclitaxelandplatinum
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