Oral glutamine ameliorates chemotherapy-induced changes of intestinal permeability and does not interfere with the antitumor effect of chemotherapy in patients with breast cancer: a prospective randomized trial.
OBJECTIVE
Sixty patients with breast cancer were randomly assigned to oral glutamine or placebo pre-neoadjuvant chemotherapy (CEF regimen).


METHODS
Oral glutamine supplementation was continued for at least 12 days. Patients kept a daily record of diarrhea and stomatitis. The plasma glutamine level, intestinal permeability (lactulose-mannitol test), and tumor size were analyzed. The expression of Ki-67 and PCNA antigens in breast carcinoma was assessed.


RESULTS
The plasma glutamine level was significantly higher in the glutamine group than in the placebo group (420.39 +/- 52.39 mmol/L vs 309.76 +/- 42.34 mmol/L, P < 0.05). After one cycle of chemotherapy, the lactulose-mannitol ratio was higher in the placebo group than in the glutamine group (0.0630 +/- 0.0091 vs 0.0471 +/- 0.0094, P < 0.05). No differences were observed in the grades of stomatitis and diarrhea, in the changes in tumor size, and in the expression of Ki-67 and PCNA antigens between the two groups.


CONCLUSIONS
Prophylactic oral glutamine could ameliorate the neoadjuvant chemotherapy-induced increase in intestinal permeability, but had no significant positive clinical effect on stomatitis and diarrhea and did not interfere with the antitumor effect of chemotherapy.
Li
Yousheng
Y
Department of Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China. liys@medmail.com.cn
Yu
Zeping
Z
Liu
Fangnan
F
Tan
Li
L
Wu
Bo
B
Li
Jieshou
J
D000284:Administration, Oral; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D002199:Capillary Permeability / Q000187:drug effects; D004334:Drug Administration Schedule; D005260:Female; D005973:Glutamine / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D006801:Humans; D007150:Immunohistochemistry; D007408:Intestinal Absorption / Q000187:drug effects*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011446:Prospective Studies; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D005973:Glutamine