Protective effect of sodium meclofenamate (SM) for radiation induced mucositis of the esophagus, large bowel and urinary bladder: A preliminary report

Sodium meclofenamate (SM) is a nonsteroidal anti-inflammatory agent which inhibits the synthesis of both prostaglandins and leukotrienes. In previous studies involving animal models, the authors found that oral SM may protect against radiation induced esophagitis, cystitis and proctitis. Lately, they investigated oral SM for radioprotection of patients irradiated to their esophagus, colon and urinary bladder in a double blind study. A dose of 100 mg tid PO or placebo is given to patients who are irradiated to their chest or their pelvis for different malignancies. Evaluation is based on clinical tolerance to irradiation and histological examination of the involved organs. Twenty-four patients were so far included in the study. Seventeen patients received SM and only 7 were given placebo. A trend was found, the initial toxicity being probably worsened by the meclomen treatment (e.g., diarrhea in 2/7 (28.6%) placebo patients and in 13/17 (76.5%) of SM treated). In contradistinction, during the 12 months followup, signs of late toxicity are significantly lower in the SM treated group (e.g. diarrhea, 4/5 (80%) in the placebo and 1/12 (8.3%) in the SM group). The initial toxicity seems to be troublesome, however, more followup of the accrued patients may be of value regarding prevention of later radiation toxicity