title: Oral glutamine supplementation during preoperative radiochemotherapy in patients with rectal cancer: a randomised double blinded, placebo controlled pilot study.
abstract: OBJECTIVE
  Enteral glutamine may have protective effects on gut function and reduce metabolic stress in patients receiving radiochemotherapy. The aim of our study was to evaluate its influence in patients with rectal cancer undergoing preoperative radiochemotherapy.
  
  
  METHODS
  We performed a randomized double blind, placebo controlled pilot study in 33 patients. 30 g of glutamine, average dose 0.41 g/kg (SD = 0.07) g/kg/day was administered orally in three doses per day for five weeks during preoperative radiochemotherapy of rectal cancer. 30 g of maltodextrin was given as placebo. Body weight was measured and NRS 2002 screening was performed before and after treatment. Bowel function was evaluated by stool consistency and frequency. Plasma levels of inflammatory parameters and hormones were measured.
  
  
  RESULTS
  There was no difference between groups in frequency and severity of diarrhoea during radiochemotherapy (p = 0.5 and p = 0.39 respectively), insulin levels significantly increased in both groups, IL-6 only in glutamine group.
  
  
  CONCLUSIONS
  Results of this small pilot study in rectal cancer patients receiving preoperative radiochemotherapy, showed that ingestion of larger quantities of glutamine given more often as previously reported did not diminish the incidence and severity of diarrhoea and did not affect inflammatory and metabolic activity compared to the placebo treatment with maltodextrin.
authors: Institute of Oncology, Zaloška 2, 1000 Ljubljana, Slovenia. nkozjek@onko-i.si
authors: Nada
authors: N
authors: Rotovnik Kozjek
authors: Lidija
authors: L
authors: Kompan
authors: Peter
authors: P
authors: Soeters
authors: Irena
authors: I
authors: Oblak
authors: Denis
authors: D
authors: Mlakar Mastnak
authors: Barbara
authors: B
authors: Možina
authors: Vesna
authors: V
authors: Zadnik
authors: Franc
authors: F
authors: Anderluh
authors: Vaneja
authors: V
authors: Velenik
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use; D000069287:Capecitabine; D055598:Chemical Phenomena; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D003967:Diarrhea / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D041981:Gastrointestinal Tract / Q000187:drug effects* / Q000503:physiopathology / Q000528:radiation effects*; D005973:Glutamine / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts; D010865:Pilot Projects; D057234:Preoperative Period; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000532:radiotherapy* / Q000601:surgery; D012720:Severity of Illness Index
chemical_list: D000964:Antimetabolites, Antineoplastic; D005973:Glutamine; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil