Oral glutamine is effective for preventing oxaliplatin-induced neuropathy in colorectal cancer patients

Wei Shu Wang, Jen Kou Lin, Tzu Chen Lin, Wei Shone Chen, Jeng Kae Jiang, Huann Sheng Wang, Tzeon Jye Chiou, Jin Hwang Liu, Chueh Chuan Yen, Po Min Chen

Research output: Contribution to journalArticlepeer-review

149 Citations (Scopus)

Abstract

Oxaliplatin is effective in the treatment of metastatic colorectal cancer (MCRC) patients; however, severe neurotoxicity develops frequently. To assess the efficacy of oral glutamine for preventing neuropathy induced by oxaliplatin, a pilot study was performed. A total of 86 patients with MCRC treated at Taipei Veterans General Hospital were enrolled. Oxaliplatin (85 mg/m2, days 1 and 15) plus weekly bolus 5-fluorouracil (5-FU; 500 mg/m2) and folinic acid (FA; 20 mg/m2) on days 1, 8, and 15 were given every 28 days as firstline treatment. Patients were randomized to receive (glutamine group; n = 42) or not receive (control group; n = 44) glutamine (15 g twice a day for seven consecutive days every 2 weeks starting on the day of oxaliplatin infusion). Efficacy of chemotherapy, neurological toxicity, and electrophysiological alterations were assessed. A lower percentage of grade 1-2 peripheral neuropathy was observed in the glutamine group (16.7% versus 38.6%) after two cycles of treatment, and a significantly lower incidence of grade 3-4 neuropathy was noted in the glutamine group after four cycles (4.8% versus 18.2%) and six cycles (11.9% versus 31.8%). By adding glutamine, interference with activities of daily living was lower (16.7% versus 40.9%), and need for oxaliplatin dose reduction was lower (7.1% versus 27.3%). There were no significant between-group differences in response to chemotherapy (52.4% versus 47.8%), electrophysiological abnormalities, grade 3-4 non-neurological toxicities (26.2% versus 22.8%), or survival. These data indicate that oral glutamine significantly reduces the incidence and severity of peripheral neuropathy of MCRC patients receiving oxaliplatin without affecting response to chemotherapy and survival.

Original languageEnglish
Pages (from-to)312-319
Number of pages8
JournalOncologist
Volume12
Issue number3
DOIs
Publication statusPublished - 2007
Externally publishedYes

Keywords

  • Colorectal carcinoma
  • Glutamine
  • Neuropathy
  • Oxaliplatin

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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