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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Clinical Nutrition
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1414367

Impact of a glutamine-enriched peptide formula on gastrointestinal toxicity and on the interruption of oncologic treatment in patients with adenocarcinoma of the rectum

Provisionally accepted
Bárbara Salas Bárbara Salas 1Laura Ferrera-Alayón Laura Ferrera-Alayón 1,2Alicia Calleja Fernández Alicia Calleja Fernández 3,4*Rodolfo Chicas-Sett Rodolfo Chicas-Sett 5Eva Nogués-Rama Eva Nogués-Rama 6Juan Zafra Juan Zafra 7Marta Lloret Marta Lloret 1,2
  • 1 Department of Radiation Oncology, University Hospital of Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain
  • 2 University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
  • 3 Open University of Catalonia, Barcelona, Spain
  • 4 Adventia Pharma S.L., Las Palmas, Spain
  • 5 Department of Radiation Oncology, ASCIRES GRUPO BIOMÉDICO, Valencia, Spain
  • 6 Department of General Surgery, University Hospital of Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain
  • 7 Department of Radiation Oncology, Virgen de la Victoria University Clinical Hospital, Málaga, Spain

The final, formatted version of the article will be published soon.

    Background: Patients with rectal cancer may develop gastrointestinal toxicity associated with chemoradiotherapeutic treatment that conditions their clinical, functional, and nutritional evolution. The aim of the study was to evaluate the efficacy of nutritional supplementation with a glutamine-enriched peptide diet (PD) compared to exclusive dietary advice (DA) on gastrointestinal toxicity, interruption of oncological treatment, and nutritional evolution in patients with rectal cancer undergoing neoadjuvant treatment. Methods: Prospective cohort study with two groups. Patients with rectal cancer in treatment with neoadjuvant chemo-radiotherapy were recruited. One group of patients received nutritional supplementation with PD, and another group received DA exclusively, from the beginning of radiotherapy until the time of surgery. Intestinal toxicity was evaluated with the CTCAE 5.0 scale, functionality with the ECOG scale and nutritional status with GLIM criteria. Results: Fifty-four patients were initially selected, although 51 were finally enrolled: 25 in the PD group and 26 in the DA group. There was a reduction in the risk of diarrhea in the PD group midway through radiotherapy treatment [RR of 0.218 (95% CI = 0.052 -0.923)] and at the end of treatment [RR of 0.103 (95% CI = 0.020 -0.537)], as well as a reduction in the risk of developing mucositis at the end of treatment [RR of 0.405 (95% CI = 0.280 -0.584)]. The use of a PD also decreased treatment interruptions with radiotherapy in stage III patients (0% vs. 15.8%, p = 0.049) and in malnourished patients (0% vs. 18.2%, p = 0.040). Conclusions: The glutamine-enriched peptide diet had a protective effect on the development of diarrhea and mucositis associated with chemo-radiotherapeutic treatment in patients with colorectal cancer under neoadjuvant treatment, as well as the interruption of radiotherapeutic treatment.

    Keywords: peptide diet, Oral nutritional supplement, Radiotherapy, rectal cancer, Glutamine

    Received: 08 Apr 2024; Accepted: 03 Dec 2024.

    Copyright: © 2024 Salas, Ferrera-Alayón, Calleja Fernández, Chicas-Sett, Nogués-Rama, Zafra and Lloret. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Alicia Calleja Fernández, Open University of Catalonia, Barcelona, Spain

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.