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

Decker-Baumann, C; Buhl, K.; Frohmüller, S.; Herbay, A. von; Dueck, Margret; Schlag, Peter M.

doi:10.1016/s0959-8049(98)00389-x

Cited by 98 publications

(54 citation statements)

References 19 publications

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“…54 Glutamine, a key 'pharmaconutrient', protects the gut during a variety of stress conditions, 55 including cancer chemotherapy. 56 Oral glutamine reduced the incidence and severity of late-onset diarrhea following CPT-11 treatment in rats. Dysbiosis induced by CPT-11-based chemotherapy increased the abundance of intestinal Enterobacteriaceae and Clostridium cluster XI.…”

Section: Microbiome and Therapeuticsmentioning

confidence: 97%

Gut microbiome and anticancer immune response: really hot Sh*t!

Viaud¹,

Daillère²,

Boneca³

et al. 2014

Cell Death Differ

113

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Section: Microbiome and Therapeuticsmentioning

confidence: 97%

Gut microbiome and anticancer immune response: really hot Sh*t!

Viaud¹,

Daillère²,

Boneca³

et al. 2014

Cell Death Differ

113

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“…A brief search of PubMed has revealed nine randomised controlled trials that administered glutamine to patients receiving chemotherapy and/or radiotherapy (11)(12)(13)(14)(15)(16)(17)(18)(19) . These studies are summarised in Table 1.…”

Section: Chemotherapy and Radiotherapymentioning

confidence: 99%

Symposium 4: Hot topics in parenteral nutrition A review of the use of glutamine supplementation in the nutritional support of patients undergoing bone-marrow transplantation and traditional cancer therapy

Crowther

2009

Proc. Nutr. Soc.

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The relationship between glutamine and malignancy can be traced back to the 1950s and the requirement for glutamine for malignant-cell growth in culture. Later studies demonstrated an association between the rate of proliferation of the malignant cells and glutamine usage. The excessive use of glutamine by malignant cells was seen as an opportunity for the development of a treatment using glutamine analogues, but unfortunately excessive toxicity was observed during clinical studies. In animal models glutamine supplementation, initially thought to increase tumour growth, actually causes tumour regression as a result of improved immune clearance of the tumour and appears to reduce the severity of the side effects of chemo- and radiotherapy. This finding led to human studies in both traditional cancer therapy and bone-marrow transplantation, which are reviewed here. Unfortunately, the majority of the studies performed are small and have poor methodological reporting. There is clinical heterogeneity in terms of routes of administration, dosing schedules, chemotherapy regimens and diseases. Studies of glutamine in non-bone-marrow transplantation chemo- and/or radiotherapy treatment suggest a possible trend towards reductions in objective mucositis but no effect on subjective symptoms. There is no evidence for its effect on other clinical outcomes. For bone-marrow transplantation there appears to be some benefit from oral glutamine in reducing mucositis and graft v. host disease, while intravenous glutamine may reduce infections but at the expense of an increased relapse rate. Good-quality studies are required in this area.

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“…[20][21][22][23][24][25][26] Additionally, the use of glutamine e specifically for individuals with colorectal cancer may have benefit. 20,24,29 This approach has been and continues to be studied. 30,31 Research protocols to date indicate appropriate dosing is approximately 10 grams of powdered glutamine, dissolved in liquid, and consumed 3 times daily for a total dose of 30 grams per day.…”

Section: Nutrition-related Complementary and Alternative Medicine Neementioning

confidence: 99%

Integrative Tumor Board: Colon Cancer with Liver Metastases

Dixon¹

2003

Integr Cancer Ther

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connected to their implanted ports. They spend the night at home, or, for patients who come to the center from outside of the Chicago area, in a nearby hotel. To use chronotherapy in an outpatient setting entails much behind-the-scenes planning and working out of details, but previous experience has shown that outpatient clinical use of this technology is quite feasible. 3Nurses function collaboratively with physicians in planning and implementing an individualized protocol for each patient. Patient and family teaching is complex, as both the patient and family need to be assured and feel comfortable about being treated with chemotherapy off-site as well as during sleep. Education needs to include basic trouble shooting for minor problems that may occur with the pump. Patients have access to nursing staff during the day and after clinic hours, through the night. Patients are provided with medications for nausea, vomiting, or diarrhea if needed and are educated thoroughly regarding these medications.Other responsibilities for our oncology nurses include research data collection, compliance with regulatory issues, quality assurance, inventory management, and continuing education on managing the technology and programming the pump. Other factors for the oncology nurse to oversee and be aware of are maintenance of the pumps, supplies, and staffing issues, as more nursing time per patient is needed initially when the patient is beginning a regimen of chronomodulated therapy. Documentation of the chemotherapy flow chart, patient assessments, and nursing care plan must be altered as well for this population of patients. Despite the increased work for nurses, a recent pharmacoeconomic analysis showed that the costs of chronotherapy and standard therapy for colon cancer using 5-FU, leucovorin, and oxaliplatin were equivalent: Although chronotherapy cost more to administer, there were fewer toxic reactions and longer time to progression. 4 Chronomodulated chemotherapy has been validated for the improvement of quality of life while undergoing treatment, including less nausea and vomiting, less diarrhea, less asthenia, and less interruption of daily activities. A growing amount of research demonstrates improved treatment outcomes as well. Family support for using chronotherapy is thus usually very strong, especially since the outpatient setting allows family members to feel more involved in the care of their loved one. Patient satisfaction is enhanced also by less need for hospital admissions and increased feeling of well-being. The initial transition to using outpatient chronotherapy did involve substantial alterations to our nursing procedures; once the new routines were incorporated, they proved to be manageable from the nursing and administrative perspectives. Home chronotherapy in our practice has proven to be a safe and acceptable alternative to traditional methods administering chemotherapy, and has provided many of our patients with a vastly improved quality of life as well as the potential for better outcomes. Refe...

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

Cited by 98 publications

References 19 publications

Gut microbiome and anticancer immune response: really hot Sh*t!

Gut microbiome and anticancer immune response: really hot Sh*t!

Symposium 4: Hot topics in parenteral nutrition A review of the use of glutamine supplementation in the nutritional support of patients undergoing bone-marrow transplantation and traditional cancer therapy

Integrative Tumor Board: Colon Cancer with Liver Metastases

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