Efficacy of famotidine in patients with acute gastric mucosal injury after continuous infusion of cisplatin plus vindesine.

The effect of famotidine (H2 blocker) on the gastroduodenal mucosal injury induced by chemotherapy in non-small-cell lung cancer patients was prospectively evaluated from the clinical and endoscopic findings obtained in a randomized double-blind study. The patients, who were administered cisplatin (25 mg/m2/day, continuous infusion, days 1-5) and vindesine (3 mg/m2, bolus, days 1 and 8), were randomized into two groups, those administered famotidine (40 mg/day, oral) and those administered the placebo. The patients were examined by gastroduodenoscopy within 7 days before and after chemotherapy. There were 27 patients in the famotidine group and 28 patients in the placebo group. The gastric mucosal score after chemotherapy was significantly lower in the famotidine group than in the placebo group (P < 0.01), and in the 42 patients without symptoms than in the 13 patients (placebo group: 8, famotidine group: 5) with upper gastrointestinal symptoms (P < 0.01). The pH of the gastric juice after the chemotherapy significantly decreased in the placebo group (P < 0.05), and was significantly lower in the placebo group than in the famotidine group (P = 0.01). The co-administration of famotidine was effective in the prevention and control of chemotherapy-induced gastric mucosal injury.