Thomas Jay
San Diego Hospice & Palliative Care, San Diego, San Diego, CA 92103, USA.
Curr Oncol Rep. 2007 Jul;9(4):278-84. doi: 10.1007/s11912-007-0034-z.
Cancer-related constipation is common and a significant detractor from patient quality of life. It has many possible causes and is still not well understood. Information is lacking on therapies for cancer-related constipation among current medications approved by the US Food and Drug Administration (FDA). Most agents have only been formally tested in comparison with placebo in chronic idiopathic constipation if at all. Few comparative studies of laxatives have been performed to establish superiority or synergy. As we understand more about the physiology of the gastrointestinal tract, new targeted therapies have become available. These include a selective chloride channel activator, lubiprostone, and a selective 5HT4 serotonin receptor agonist, tegaserod, both of which have been FDA approved for chronic idiopathic constipation. The role of these agents in cancer-related constipation remains to be seen. On the horizon are two investigational peripherally acting opioid receptor antagonists, alvimopan and methylnaltrexone. Preliminary results in cancer-related constipation suggest that these agents may be important additions to our treatment repertoire.
癌症相关的便秘很常见，严重影响患者的生活质量。它有多种可能的病因，目前仍未被充分了解。在美国食品药品监督管理局（FDA）批准的现有药物中，缺乏针对癌症相关便秘的治疗信息。大多数药物即便进行过测试，也只是在慢性特发性便秘中与安慰剂进行过对比。很少有关于泻药的比较研究来确定其优越性或协同作用。随着我们对胃肠道生理学的了解越来越多，新的靶向治疗方法已经出现。这些方法包括一种选择性氯离子通道激活剂鲁比前列酮和一种选择性5-HT4血清素受体激动剂替加色罗，这两种药物均已被FDA批准用于治疗慢性特发性便秘。这些药物在癌症相关便秘中的作用还有待观察。即将出现的是两种正在研究的外周作用阿片受体拮抗剂，阿维莫潘和甲基纳曲酮。在癌症相关便秘方面的初步结果表明，这些药物可能会成为我们治疗方案中的重要补充。
