Published online Apr 15, 2000. doi: 10.3748/wjg.v6.i2.255
Revised: November 26, 1999
Accepted: December 3, 1999
Published online: April 15, 2000
AIM: To investigate the interference of methionine-free parenteral nutrition plus 5-Fu (MetTPN+5-Fu) in gastric cancer cell kinetics and the side effects of the regimen.
METHODS: Fifteen patients with advanced gastric cancer were randomly divided into two groups, 7 patients were given preoperatively a seven-day course of standard parenteral nutrition in combination with a five-day course of chemotherapy (sTPN+5-Fu), while the other 8 patients were given methionine-deprived parenteral nutrition and 5-Fu (MetTPN+5-Fu). Cell cycles of gastric cancer and normal mucosa were studied by flow cytometry (FCM). Blood samples were taken to measure the serum protein, methionine (Met) and cysteine (Cys) levels, and liver and kidney functions.
RESULTS: As compared with the results obtained before the treatment, the percentage of G0/G1 tumor cells increased and that of S phase decreased in the MetTPN+5-Fu group, while the contrary was observed in the sTPN+5-Fu group. Except that the ALT, AST and AKP levels were slightly increased in a few cases receiving MetTPN+5-Fu, all the other biochemical parameters were within normal limits. Serum Cys level decreased slightly after the treatment in both groups. Serum Met level of patients receiving sTPN+5-Fu was somewhat higher after treatment than that before treatment; however, no significant change occurred in the MetTPN+5-Fu group, nor operative complications in both groups.
CONCLUSION: MetTPN+5-Fu exerted a suppressive effect on cancer cell proliferation, probably through a double mechanism of creating a state of "Met starvation" adverse to the tumor cell cycle, and by allowing 5-Fu to kill specifically cells in S phase. Preoperative short-term administration of -MetTPN+5-Fu had little undesirable effect on host metabolism.