Prevention of damages of the gastric and duodenal mucosa during chemotherapy

   The main goal of the study was to prevent the development of gastric and duodenal ulcers in patients with colorectal cancer receiving adjuvant therapy with 5-fluorouracil.

   Materials and methods. The study included 60 patients with a verified diagnosis of localized or locally advanced colon and rectosigmoid cancer after radical surgical treatment. The patients are divided into two groups. The first group included 28 people who were found to have Helicobacter pylori during fibrogastroduodenoscopy and 13C-respiratory urease test. Patients underwent anti-Helicobacter and gastroprotective therapy before adjuvant chemotherapy with 5-fluorouracil according to the developed scheme. The second group included 32 people. Tests for infection with Helicobacter pylori in these patients were negative, they did not receive gastroprotective therapy.

   Research results. The study showed the effectiveness of prophylactic therapy administered to patients from the first group before the start of the adjuvant chemotherapy program, since ulcerative lesions of the mucous membranes of the stomach and duodenum in patients were detected less frequently, responded better to conservative therapy, and also did not cause a delay in the next course of drug treatment. including 5-fluorouracil. When preventive antiulcer treatment was administered, the chance of developing ulcer complications in patients decreased by 5.08 times. The most vulnerable in terms of mucosal damage were female patients of elderly and senile age, complications developed even against the background of antiulcer treatment.

1. Kaprin A. D., Starinskiy V. V., Shakhzadova A. O. Malignant neoplasms in Russia in 2020 (morbidity and mortality). Moscow : P. A. Herzen Institute of Medical Research − Branch of the Federal State Budgetary Institution «NMIC of Radiology» of the Ministry of Health of Russia; 2021. 252 p. (In Russ.).

2. Blondy S., David V., Verdier M., Mathonnet M., Perraud Au., Christou N. 5‐Fluorouracil resistance mechanisms in colorectal cancer : From classical pathways to promising processes // Cancer Science. 2020. Vol. 111, no. 9. P. 3142–3154.

3. Donyush E. K., Tiganova O. A., Abuzin M. N., Bel'mer S. V. Diagnosis and treatment of gastroenterological complications of chemotherapy in oncohematological patients in pediatric practice. Lechashchiy vrach = Attending physician. 2017; (1): 27–33. (In Russ.).

4. Rejhová A. Opattová A., Čumová A., Vodička P., Slíva D. Natural compounds and combination therapy in colorectal cancer treatment // European Journal of Medicinal Chemistry. 2018. Vol. 144. P. 582–594.

5. Fedyanin M. Yu., Achkasov S. I., Bolotina L. V., Gladkov O. A., Glebovskaya V. V., Gordeev S. S., Karachun A. M., Kozlov N. A., Lyubchenko L. N., Malikhova O. A., Mamedli Z. Z., Medvedeva B. M., Obukhova O. A., Petrov A. S., Podluzhnyy D. V., Protsenko S. A., Ryzhkov A. D., Rykov I. V., Sidorov D. V., Tryakin A. A., Tsukanov A. S., Shelygin Yu. A. Practical recommendations for the drug treatment of colon cancer and rectosigmoid compound. Zlokachestvennye opukholi = Malignant tumors. 2020; (10 (3s2-1)): 350–391. (In Russ.). doi: 10.18027/2224-5057-2020-10-3s2-22.

6. Andreev D. N., Maev I. V., Kucheryavyy Yu. A. Helicobacter pylori resistance in the Russian Federation: Meta-analysis of studies over the past 10 years. Terapevticheskiy arkhiv = Therapeutic archive. 2020; 92 (11): 24–30. (In Russ.).

7. Kattakhanova R. Yu. Modern methods of treatment of helicobacter-associated diseases of the stomach and duodenum. New Horizons - 2021 : collection of materials of the VIII Belarusian-Chinese Youth Innovation Forum, November 11-12, 2021. Minsk : Belarusian National Technical University; 2021. Vol. 1. pp. 88–89. (In Russ.).

8. Minushkin O. N., Zverkov I. V., L'vova N. V., Skibina Yu. S., Inevatova V. S. Chronic gastritis: the current state of the problem. Terapevticheskiy arkhiv = Therapeutic archive. 2020; 92 (8): 18–23. (In Russ.).

9. Uspenskiy Yu. P., Baryshnikova N. V., Fominykh Yu. A., Rustamov M. N., Sarsenbaeva A. S. I International Congress of Cardiologists and Therapists : Collection of scientific tr., Minsk, May 12-13, 2016 / Ed. N. P. Mitkovskaya. Minsk : Kapital Print; 2016. pp. 290–302. (In Russ.).

10. Shevchenko A. S., Savchuk V. V. Chronic gastritis. Vestnik nauchnogo obshchestva studentov, aspirantov i molodykh uchenykh = Bulletin of the Scientific Society of Students, postgraduates and young scientists. 2017; (3): 175–179. (In Russ.).

11. Ansari S., Yamaoka Y. Helicobacter pylori virulence factors exploiting gastric colonization and its pathogenicity // Toxins. 2019. Vol. 11, no. 11. P. 677.

12. Crowe S. E. Helicobacter pylori infection // New England Journal of Medicine. 2019. Vol. 380, no. 12. P. 1158–1165.

13. De Brito B. B., França da Silva F. A., Soares A. S., Pereira V. A., Cordeiro Santos M. L., Sampaio M. M., Moreira Neves P. H., De Melo F. F. Pathogenesis and clinical management of Helicobacter pylori gastric infection // World journal of gastroenterology. 2019. Vol. 25, no. 37. P. 5578.

14. Pozdeeva A. O., Pozdeev O. K., Gulyaev P. E., Valeeva Yu. V., Savinova A. N. Modern development of Helicobacter pylori eradication schemes. Infektsiya i immunitet = Infection and immunity. 2021; 11 (6): 1037–1049. (In Russ.).

15. Lazebnik L. B., Tkachenko E. I., Abdulganieva D. I., Abdulkhakov R. A., Abdulkhakov S. R., Avalueva E. B., Ardatskaya M. D., Akhmedov V. A., Bordin D. S., Burkov S. G., Butov M. A., Golovanova E. V., Golofeevskiy V. Yu., Grinevich V. B., Dzhulay G. S., Dobritsa V. P., Eremina E. Yu., Zhigalova T. N., Ivanikov I. O., Isakov V. A., Kazyulin A. N., Kalinin A. V., Kozlova I. V., Komissarenko I. A., Kornienko E. A., Korochanskaya N. V., Kurilovich S. A., Kucheryavyy Yu. A., Li E. D., Li I. A., Levchenko S. V., Livzan M. A., Loginov A. F., Loranskaya I. D., Maev I. V., Maksimov V. A., Miller D. A., Minushkin O. N., Nizov A. A., Oreshko L. S., Osipenko M. F., Pal'tsev A. I., Pasechnikov V. D., Radchenko V. G., Rustamov M. N., Sablin O. A., Sagynbaeva V. E., Sayfutdinov R. G., Samsonov A. A., Sarsenbaeva A. S., Seliverstov P. V., Simanenkov V. I., Sitkin S. I., Starostin B. D., Suvorov A. N., Tarasova L. V., Tkachev A. V., Uspenskiy Yu. P., Khlynova O. V., Khomeriki N. M., Khomeriki S. G., Tsukanov V. V., Chernin V. V., Chernyshev A. L., Sharkhun O. O., Shcherbakov P. L., Yakovenko E. P. VI National recommendations for the diagnosis and treatment of acid-dependent and Helicobacter pylori-associated diseases (VI Moscow Agreements). Eksperimental'naya i klinicheskaya gastroenterologiya = Experimental and clinical gastroenterology. 2017; (2 (138)): 3–21. (In Russ.).

16. Styazhkina S. N., Mukhamadieva A. R., Nikolaeva Yu. N., Vasil'ev A. D., Zhuykova A. A. Management and treatment of patients with a complication of gastric ulcer. StudNet. 2021; 4 (1): 26. (In Russ.).

17. Bordin D. S., Voynovan I. N., Kolbasnikov S. V., Embutnieks Yu. V. Methods of diagnosis of Helicobacter pylori infection in clinical practice. Terapevticheskiy arkhiv = Therapeutic archive. 2018; 90 (12): 133–139. (In Russ.).

18. Golubkina E. V., Kamneva N. V., Umerova A. R. The role of the CagA gene in the diagnosis of Helicobacter pylori-associated diseases of the stomach and duodenum. Astrakhanskiy meditsinskiy zhurnal = Astrakhan Medical Journal. 2017; 12 (2): 8–14. (In Russ.).

19. Golubkina E. V., Levitan B. N., Umerova A. R., Kamneva N. V. Some epidemiological aspects of helicobacteriosis. Astrakhanskiy meditsinskiy zhurnal = Astrakhan Medical Journal. 2018; 13 (2): 6–16. (In Russ.).

20. Vodenkova S. Buchler T., Cervena K., Veskrnova V., Vodicka P., Vymetalkova V. 5-fluorouracil and other fluoropyrimidines in colorectal cancer : Past, present and future // Pharmacology & therapeutics. 2020. Vol. 106. P. 107447.

21. Xie P., Mo J.-L., Liu J.-H., Li X., Tan L.-M., Zhang W., Zhou H.-H., Liu Z.-Q. Pharmacogenomics of 5-fluorouracil in colorectal cancer: review and update // Cellular Oncology. 2020. Vol. 43, no. 6. P. 989–1001.