ABSTRACT
The toxicity of chemotherapy or radiation therapy to bone marrow hematopoietic elements and gastrointestinal epithelia are the most important factors limiting the dose of cytotoxic therapy. The advent colony–stimulating factors which stimulate hematopoiesis and may enhance recovery from chemotherapy–induced neutropenia will serve to place chemotherapy–induced toxicity to gastrointestinal epithelium at center stage, as the dose-limiting factor in cancer treatment. Various studies suggests that strict elemental diets protect gastrointestinal epithelia from chemotherapy and radiation. Diets that are completely elemental contain nitrogen in the form of individual amino acids instead of polymeric proteins. It has been known for years that diversion of biliary and pancreatic secretions enhances intestinal epithelial tolerance to radiation. The use of parenteral nutrition during cancer chemotherapy is associated with a fourfold increase in the risk of infection. Lipid infusions may be the component of parenteral nutrition that is largely responsible for increasing the risk of infection.
