Glutamine prevents diarrhea in colorectal cancer patients undergoing chemotherapy or chemoradiotherapy: a meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 41053591 · doi:10.1186/s12876-025-04308-w
What was done
A systematic review and meta-analysis following PRISMA 2020 guidelines and registered on INPLASY (INPLASY202490057). The authors searched PubMed, Cochrane Library, EMBASE, CNKI, and Wanfang through August 1, 2024, for randomized controlled trials assessing glutamine supplementation in preventing chemotherapy- or chemoradiotherapy-induced diarrhea in colorectal cancer patients. Outcomes were pooled using relative risk (RR) or mean difference (MD) with 95% confidence intervals (CIs).
What was found
Across 5 included RCTs involving 311 patients: - Diarrhea incidence was significantly reduced with glutamine compared to control (RR = 0.72, 95% CI: 0.60–0.87, P < 0.01, I² = 37%). - Subgroup analysis showed glutamine reduced diarrhea in patients receiving chemotherapy alone (RR = 0.65, 95% CI: 0.43–0.98, P < 0.05, I² = 35%). - By tumor location, diarrhea was reduced in the colorectal cancer subgroup (RR = 0.65, 95% CI: 0.44–0.97, P < 0.05, I² = 30%), but not in the rectal cancer subgroup (P > 0.05). - D-xylose levels were significantly higher in the glutamine group (MD = 0.32, 95% CI: 0.14–0.51, P < 0.01, I² = 0%), and C-reactive protein levels were significantly lower (MD = 0.52, 95% CI: 0.32–0.72, P < 0.01, I² = 0%). - The certainty of evidence for diarrhea was rated as low.
Why it matters
Glutamine supplementation may help reduce gastrointestinal toxicity during colorectal cancer treatment, with the clearest benefit observed in patients receiving chemotherapy alone.
Limits
The meta-analysis is based on a small total sample size (5 trials, 311 patients), and the overall certainty of evidence was graded as low. Subgroup benefits were not observed in rectal cancer, and the abstract does not report specific glutamine doses, routes of administration, or chemotherapy regimens.
Cited by
- supports Glutamine supplementation is used in oncology to help patients recover from and combat the side effects of chemotherapy.