Reduction of chemotherapy-induced side-effects by parenteral glutamine supplementation in patients with metastatic colorectal cancer.

In animal studies, glutamine (Gln) reduces chemotherapy-associated mucositis and mucosal atrophy. Therefore, this study examined the protective effects of a parenteral Gln supplementation in patients with metastatic colorectal carcinoma receiving 5-fluorouracil (5-FU)/calcium-folinate (CF) chemotherapy. In a prospective study, a total of 24 patients underwent three courses of 5-FU/CF chemotherapy and were randomised with (n = 12) or without (n = 12) glycyl-L-glutamine. Effects on gastrointestinal mucosa were assessed by endoscopic examinations and histomorphometric measurements. Clinical side-effects were documented according to the World Health Organisation grading. In the Gln group, a significant reduction in mucositis and ulcerations of the gastric (P < 0.01) and duodenal mucosa (P < 0.05) was documented after the third course of chemotherapy. In the same group, the villus height/crypt depth ratio was significantly higher after therapy than in the unsupplemented group (1st course P < 0.01; 3rd course P < 0.05). However, there were no significant differences in the incidence and severity of clinical side-effects. The results suggest that parenteral Gln supplementation protects the gastrointestinal mucosa against 5-FU/CF chemotherapy-induced damage.
AuthorsC Decker-Baumann, K Buhl, S Frohmüller, A von Herbay, M Dueck, P M Schlag
JournalEuropean journal of cancer (Oxford, England : 1990) (Eur J Cancer) Vol. 35 Issue 2 Pg. 202-7 (Feb 1999) ISSN: 0959-8049 [Print] ENGLAND
PMID10448260 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Glutamine
  • Leucovorin
  • Fluorouracil
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects)
  • Colorectal Neoplasms (drug therapy)
  • Female
  • Fluorouracil (administration & dosage, adverse effects)
  • Glutamine (therapeutic use)
  • Humans
  • Infusions, Parenteral
  • Intestinal Mucosa (drug effects)
  • Leucovorin (administration & dosage, adverse effects)
  • Male
  • Middle Aged
  • Prospective Studies

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