Polyamine reduced diet (PRD) nutrition therapy in hormone refractory prostate cancer patients.
BACKGROUND
Reducing polyamine uptake by selecting low polyamine-containing foodstuffs and reducing bacterial gut production can improve performance status and pain control in hormone refractory prostate cancer (HRPC) patients. Long term PRD observance and tolerance were assessed. Cancer specific survival was studied in function of PRD and time of PRD initiation.


METHODS
Twenty-six volunteers, age: 68+/-10 years with metastatic HRPC accepted a polyamine reduced diet and partial gut decontamination with oral neomycin or nifuroxazide (750 mg daily, one week out of two). Time from HRPC to PRD initiation was 10+/-8 months. WHO performance status, EORTC pain scale, body weight, blood counts and serum proteins were regularly assessed. Sixteen other HRPC patients eating a normal diet served as "controls".


RESULTS
Mean diet observance is 25+/-24 months. Tolerance is good. WHO performance status and EORTC pain scales were significantly improved respectively at 3 months (0.5+/-0.7 vs 0.7+/-0.9: p=0.03) and 6 months (0.5+/-0.8 vs 1+/-1.3, p=0.02) compared to initial values. Median cancer specific survival times after HRPC and PRD initiation are respectively 36 and 21 months. Eleven PRD patients started the diet before a 9 months cut-off period (after HRPC) and 15 patients after. Median cancer specific survival times for these two groups of patients are respectively 44 and 34 months, p=0.014. Median cancer specific survival times (after HRPC) for PRD patients compared to controls are 36 vs 17 months (p=0.004).


CONCLUSIONS
Polyamine-reduced diet is well observed and tolerated. It seems to improve and/or maintain quality of life for HRPC patients. Early PRD initiation in HRPC is promising and may impact favorably cancer specific survival. These results open a rationale for PRD in HRPC management and warrant further investigation.
Cipolla
Bernard G
BG
Department of Urology, Centre Hospitalier Privé Saint-Grégoire, 6 Boulevard de la Boutière, 35760 Saint-Grégoire, France. bcipolla@cpa-sante.com
Havouis
René
R
Moulinoux
Jacques-Philippe
JP
D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D003666:Decontamination / Q000379:methods; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D062385:Hydroxybenzoates / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009355:Neomycin / Q000627:therapeutic use; D009581:Nitrofurans / Q000627:therapeutic use; D010146:Pain / Q000178:diet therapy / Q000209:etiology; D010147:Pain Measurement; D011073:Polyamines / Q000008:administration & dosage*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000178:diet therapy* / Q000473:pathology; D011788:Quality of Life; D013534:Survival; D013997:Time Factors; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D062385:Hydroxybenzoates; D009581:Nitrofurans; D011073:Polyamines; D009355:Neomycin; C013150:nifuroxazide