Oral glutamine supplementation during preoperative radiochemotherapy in patients with rectal cancer: A randomised double blinded, placebo controlled pilot study

Clinical Nutrition

Volumn 30, Issue 5, 2011, Pages 567-570

  Rotovnik Kozjek, Nada ^a   Kompan, Lidija ^a   Soeters, Peter ^b   Oblak, Irena ^a   Mlakar Mastnak, Denis ^a   Možina, Barbara ^a   Zadnik, Vesna ^a   Anderluh, Franc ^a   Velenik, Vaneja ^a  

^a INSTITUTE OF ONCOLOGY   (Slovenia)

^b MAASTRICHT UNIVERSITY   (Netherlands)

Author keywords

Diarrhoea; Enteral; Glutamine; Inflammation; Metabolic stress; Preoperative; Radiochemotherapy; Rectal cancer

Indexed keywords

CAPECITABINE; GLUTAMINE; INSULIN; INTERLEUKIN 6; MALTODEXTRIN; PLACEBO;

ADULT; ARTICLE; BODY WEIGHT; CANCER CHEMOTHERAPY; CANCER RADIOTHERAPY; CANCER STAGING; CHEMORADIOTHERAPY; CLINICAL ARTICLE; CLINICAL EFFECTIVENESS; CLINICAL EVALUATION; CONTROLLED STUDY; DEFECATION HABIT; DIARRHEA; DISEASE SEVERITY; DOUBLE BLIND PROCEDURE; DRUG EFFECT; FEMALE; HUMAN; INSULIN BLOOD LEVEL; INTESTINE MOTILITY; MALE; METABOLIC STRESS; PILOT STUDY; PREOPERATIVE CARE; PROTEIN BLOOD LEVEL; RADIATION DOSE DISTRIBUTION; RANDOMIZED CONTROLLED TRIAL; RECTUM CANCER; TREATMENT DURATION;

AGED; ANTIMETABOLITES, ANTINEOPLASTIC; CHEMORADIOTHERAPY, ADJUVANT; DEOXYCYTIDINE; DIARRHEA; DIETARY SUPPLEMENTS; DOUBLE-BLIND METHOD; FEMALE; FLUOROURACIL; GASTROINTESTINAL TRACT; GLUTAMINE; HUMANS; INCIDENCE; MALE; MIDDLE AGED; PATIENT DROPOUTS; PHYSICOCHEMICAL PHENOMENA; PILOT PROJECTS; PREOPERATIVE PERIOD; RECTAL NEOPLASMS; SEVERITY OF ILLNESS INDEX;

EID: 80053645712     PISSN: 02615614     EISSN: 15321983     Source Type: Journal    
DOI: 10.1016/j.clnu.2011.06.003     Document Type: Article

References (29)

1. Biolo G., Fleming R.Y.D., Maggi S.P., Nguyen T.T., Herndon D.N., Wolfe R.R. Inhibition of muscle glutamine formation in hypercatabolic patients. Clin Sci 2000, 99:189-194.
2. McCauley R., Kong S.E., Hall J. Glutamine and nucleotide metabolism within enterocytes. J Parenter Enteral Nutr 1998, 22:105-111.
3. Yaqoob P., Calder P.C. Glutamine requirements of proliferating T lymphocytes. Nutrition 1997, 13:646-651.
4. Li P., Yin Y.L., Li D., Kim S.W., Wu G. Amino acids and immune function. Br J Nutr 2007, 98:237-252.
5. Ziegler T.R., Szeszycki E.E., Estívariz C.F., Puckett A.B., Leader L.M. Glutamine from basic science to clinical applications. Nutrition 1996, 12:S68-S70.
6. Savarese D.M., Savy G., Vahdat L., Wischmeyer P.E., Corey B. Prevention of chemotherapy and radiation toxicity with glutamine. Cancer Treat Rev 2003, 29:501-513.
7. Kuhn S.K., Muscaritoli M., Wischmeyer P., Stehle P. Glutamine as indispensable nutrient in oncology: experimental and clinical evidence. Eur J Nutr 2009, 49:197-210.
8. De Blaauw I., Deutz N.E., van der Hulst R.R., von Meyenfeldt M.F. Glutamine depletion and increased gut permeability in nonanorectic, non-weight-losing tumor-bearing rats. Gastroenterology 1997, 112:118-126.
9. Deutz N.E.P., Reijven P.L., Athanasas G., Soeters P.B. Post-operative changes in hepatic, intestinal, splenic and muscle fluxes of amino acids and ammonia in pigs. Clin Sci 1992, 83:607-614.
10. Van der Hulst R.R., von Meyenfeldt M.F., Deutz N.E., Soeters P.B. Glutamine extraction by the gut is reduced in depleted [corrected] patients with gastrointestinal cancer. Ann Surg 1997, 225(1):112-121.
11. Diestel C.F., Marques R.G., Lopes-Paulo F., Paiva D., Horst N.L., Caetano C.E., et al. Role of L-glutamine and glycine supplementation on irradiated colonic wall. Int J Colorectal Dis 2007, 22:1523-1529.
12. Erbil Y., Oztezcan S., Giriş M., Barbaros U., Olgaç V., Bilge H., et al. The effect of glutamine on radiation-induced organ adamage. Life Sci 2005, 78:376-382.
13. Salman B., Oguz M., Akmansu M., Bebitoglu I., Akca G., Sultan N., et al. Effect of timing of glutamine enriched intestinal damage caused by irradiation. Adv Ther 2007, 24:648-661.
14. Daniele B., Perrone F., Gallo C., Pignata S., De Martino S., De Vivo R., et al. Oral glutamine in the prevention of flourouracil induced intestinal toxicity; a double blind, placebo controlled randomized trial. Gut 2001, 48:28-33.
15. Choi K., Lee S.S., Oh S.J., Lim S.Y., Lim S.Y., Jeon W.K., et al. The effect of oral glutamine on 5-fluorouracil/leucovorin-induced mucositis/stomatitis assessed by intestinal permeability test. Clin Nutr 2007, 26:57-62.
16. Pan C.X., Loehrer P., Seitz D., Helft P., Juliar B., Ansari R., et al. A phase II trial of irinotecan, 5-fluorouracil and leucovorin combined with celocoxib and glutamine as first-line therapy for advanced colorectal cancer. Oncology 2005, 69:63-70.
17. Melis G.C., Boelens P.G., van der Sijp J.R., Popovici T., De Bandt J.P., Cynober L., et al. The feeding route (enteral or parenteral) affects the plasma response of the dipeptide Ala-Gln and the amino acids glutamine, citrulline and arginine, with the administration of Ala-Gln in preoperative patients. Br J Nutr 2005, 94:19-26.
18. Arends J., Bodoky G., Bozzetti F., Fearon K., Muscaritoli M., Selga G., et al. ESPEN guidelines on enteral nutrition: non-surgical oncology. Clin Nutr 2006, 25:245-259.
19. García-de-Lorenzo A., Zarazaga A., García-Luna P.P., Gonzalez-Huix F., López-Martínez J., Miján A., et al. Clinical evidence for enteral nutritional support with glutamine: a systematic review. Nutrition 2003, 19:805-811.
20. Kondrup J., Rasmussen H.H., Hamberg O., Stanga Z. Nutritional Risk Screening (NRS 2002): a new method based on a analysis of controlled clinical trials. Clin Nutr 2003, 22:321-336.
21. Sauer R., Becker H., Hohenberger W., Rödel C., Wittekind C., Fietkau R., et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 2004, 351:1731-1740.
22. Kozelsky T.F., Meyers G.E., Sloan J.A., Shanahan T.G., Dick S.J., Moore R.L., et al. Martenson JA;. Phase III double-blind study of glutamine versus placebo for the prevention of acute diarrhea in patients receiving pelvic radiation therapy. J Clin Oncol 2003, 21:1669-1674.
23. Huang E.Y., Leung S.W., Wang C.J., Chen H.C., Sun L.M., Fang F.M., et al. Oral glutamine to alleviate radiation-induced oral mucositis: a pilot randomized trial. Int J Radiat Oncol Biol Phys 2000, 200(46):535-539.
24. Yoshida S., Matsui M., Shirouzu y, Fujita H., Yamana H., Shirouzu K. Effect of glutamine supplements and radiochemotherapy on systemic immune and gut barrier function in patients with advance esophageal cancer. Annal Surg 1998, 227:485-491.
25. Bozzetti F., Biganzoli L., Gavazzi C., et al. Glutamine supplementation in cancer patients receiving chemotherapy: a double-blind randomized study. Nutrition 1997, 13:748-751.
26. Novak F., Heyland D.K., Avenell A., Drover J.W., Su X. Glutamine supplementation in serious illness: a systematic review of the evidence. Crit Care Med 2002, 30:2022-2029.
27. Muscaritoli M., Micozzi A., Conversano L., Martino P., Petti M.C., Cartoni C., et al. Oral glutamine in the prevention of chemotherapy-induced gastrointestinal toxicity. Eur J Cancer 1997, 33:319-320.
28. Ligthart-Melis G.C., Van de Poll M.C., Dejong C.H., Boelens P.G., Deutz N.E., Van Leeuwen P.A. The route of administration (enteral or parenteral) affects the conversion of isotopically labelled L - [2-15N] glutamine into citrulline and arginine in humans. JPEN J Parenter Enteral Nutr 2007, 31:343-350.
29. Griffiths R.D. Glutamine in the critically ill patient: can it affect mortality?. Clin Nutr 2004, 1(Suppl. 1):25-32.