The effect of oral glutamine on 5-fluorouracil/leucovorin-induced mucositis/stomatitis assessed by intestinal permeability test
- Authors
- Choi, Kwon; Lee, Seung Sei; Oh, Suk Joong; Lim, Seong Yong; Lim, Si Young; Jeon, Woo Kyu; Oh, Tae Yun; Kim, Jeong Wook
- Issue Date
- Feb-2007
- Publisher
- CHURCHILL LIVINGSTONE
- Keywords
- chemotherapy; intestinal permeability; glutamine; mucositis; stomatitis
- Citation
- CLINICAL NUTRITION, v.26, no.1, pp 57 - 62
- Pages
- 6
- Journal Title
- CLINICAL NUTRITION
- Volume
- 26
- Number
- 1
- Start Page
- 57
- End Page
- 62
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/24167
- DOI
- 10.1016/j.clnu.2006.07.003
- ISSN
- 0261-5614
1532-1983
- Abstract
- Background Et aims: Systemic chemotherapy may damage gastrointestinal epithelium. Mucositis is associated with increased intestinal permeability (IP). It is known that IP test with chromium 51-ethylene diaminetetra-acetate (Cr-51-EDTA) is a useful tool to assess the mucositis. Oral glutamine supplements (OGS) may have a role in the prevention of chemotherapy-induced mucositis/stomatitis. The aim of this study was to characterize the relationship between the urinary excretion of Cr-51-EDTA and the severity of mucositis, and the effect of OGS on 5-fluorouracil/leucovorin (FU/LV)-induced mucositis/stomatitis. Methods: Fifty-one patients with advanced or metastatic cancer received FU/LV chemotherapy. The control. group included 18 healthy volunteers. IP was assessed via the measurement of Cr-51-EDTA urinary excretion after oral challenge, on days 7 after the discontinuation of chemotherapy. Of the 51 patients, 22 patients received OGS (30 g/day) and 29 received only best supportive care (BSC). Glutamine supplementation continued for 15 days. It was initiated at least 3 days before the beginning of chemotherapy. Mucositis/ stomatitis was graded according to version 3.0 of the Common Terminology Criteria for Adverse Events. Results: In the chemotherapy group, the median (25 percentile, 75 percentile) IP test score was significantly higher than those of the control group [6.78% (4.63, 10.66) vs. 2.17% (1.38, 2.40), P < 0.001]. The severity of stomatitis was significantly correlated with IP test scores (r = 0.898, P < 0.001). In the OGS group, the median IP test score was significantly lower than that of the BSC group [4.69% (3.10, 6.48) vs. 8.54% (6.48, 15.31), P < 0.001]. A mucositis/stomatitis of grade 2-4 was observed in two patients of the OGS group (9%), and in 11 patients (38%) in the BSC group (P < 0.001). Conclusions: The IP test may be a useful tool. in the evaluation of mucositis/stornatitis. OGS may exert a protective effect on FU/LV-induced mucositis/stomatitis. Further studies, however, will be necessary to define the role of glutamine supplementation in FU/LV-induced mucositis/stomatitis. (c) 2006 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
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