Abstract:
:Chemotherapeutic agents may damage gastrointestinal epithelium and thereby impair the mucosal barrier to bacteria and their products. In order to obtain an objective measurement of gastrointestinal permeability to large molecules, we measured urinary excretion of [14C]polyvinylpyrrolidone administered p.o. (mean molecular weight 11,000) and tobramycin (molecular weight 467) in ten patients receiving 5-fluorouracil therapy for metastatic cancer of the colon. Base-line absorption of [14C]polyvinylpyrrolidone was 0.013 to 0.048% of the administered dose. Dose-related increases in absorption (range, two to 20 fold) occurred after 5-fluorouracil administration, but the dose response differed markedly between individuals. Absorption was maximal 8 to 15 days after the start of therapy, was correlated in time but not necessarily in severity with the presence of gastrointestinal symptoms, and was unaffected by oral nonabsorbable antibiotics. Tobramycin excretion was 8.5 times greater than [14C]polyvinylpyrrolidone excretion, but the two were highly correlated in simultaneous determinations (r, 0.93; p, < 0.001). With the exception of an episode of Escherichia coli bacteremia, infections coincided not with maximal [14C]polyvinylpyrrolidone absorption but with maximal granulocytopenia 17 to 24 days after the start of therapy. The gastrointestinal absorption of polyvinylpyrrolidone provides an objective measurement of mucosal integrity which may have applications in assessing the gastrointestinal toxicity of other cytotoxic agents.
journal_name
Cancer Resjournal_title
Cancer researchauthors
Siber GR,Mayer RJ,Levin MJsubject
Has Abstractpub_date
1980-10-01 00:00:00pages
3430-6issue
10eissn
0008-5472issn
1538-7445journal_volume
40pub_type
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