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The protective effects of glutamine on radiation-induced diarrhea

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Abstract

Introduction

Glutamine is a neutral amino acid that is used by rapidly dividing cells such as erythrocytes, lymphocytes, and fibroblasts. It is also the substrate of glutathione synthesis. In normal metabolic rates, glutamine is an amino acid synthesized endogenously, but in high metabolic conditions such as cancer, it must be taken exogenously. Animal studies strongly demonstrate that glutamine protects both the upper and lower gastrointestinal tract mucosa from the effects of chemotherapy, radiotherapy, or other causes of injury. In this study, we investigated the protective effect of glutamine on radiation-induced diarrhea.

Patients and method

The patients were divided into glutamine-treated and placebo groups. In the glutamine-treated group, 15 g of oral glutamine was administered three times daily. The patients were evaluated for diarrhea grade according to the National Cancer Institute Common Toxicity Criteria version 3.0, (Table 1), need for loperamide use, need for supportive parenteral therapy, and treatment breaks due to diarrhea.

Results

There was no difference in overall diarrhea incidence when the two groups were compared. When diarrhea grade was evaluated, none of the patients in the glutamine-treated group had grade 3–4 diarrhea, but in the placebo group, grade 3–4 diarrhea was seen in 69 % of the patients. In the placebo-treated group, patients requiring loperamide and parenteral supportive therapy were 39 and 92 %, respectively. There was no treatment break in glutamine-treated patients.

Conclusion

Glutamine may have protective effect on radiation-induced severe diarrhea.

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Authors and Affiliations

  1. Department of Radiation Oncology, Kanuni Training and Research Hospital, Trabzon, Turkey

    Eda Kucuktulu

  2. Department of General Surgery, Kanuni Training and Research Hospital, Trabzon, Turkey

    Ali Guner, Izzettin Kahraman & Uzer Kucuktulu

  3. Department of Public Health, Karadeniz Technical University, Trabzon, Turkey

    Murat Topbas

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  1. Eda Kucuktulu
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  2. Ali Guner
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  3. Izzettin Kahraman
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  4. Murat Topbas
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  5. Uzer Kucuktulu
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Correspondence to Eda Kucuktulu.

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Kucuktulu, E., Guner, A., Kahraman, I. et al. The protective effects of glutamine on radiation-induced diarrhea. Support Care Cancer 21, 1071–1075 (2013). https://doi.org/10.1007/s00520-012-1627-0

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  • DOI: https://doi.org/10.1007/s00520-012-1627-0

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