Background. Peritoneal carcinomatosis (PC) accompanied with ascites formation causes several distressing symptoms, resulting in poor quality of life. Methods. Twenty BALB/c nude mice generated by direct orthotopic injection of human pancreatic cancer PANC-1 cells were randomized to receive either a stock laboratory diet or a stock diet supplemented with glutamine. Half of the mice were sacrificed at day 76 to measure the amount of ascitic fluid and pancreatic tumor volume. The remaining mice were subject to survival analysis. Serum albumin levels were estimated every 2 weeks. Results. At day 76, the average amount of ascitic fluid measured in the control group was ？mL compared to ？mL from the glutamine-supplemented mice ( ). The volume of pancreatic tumor was ？cm3 in the control group and ？cm3 in glutamine-supplemented mice ( ). The mean survival time of glutamine-supplemented mice was prolonged from to days ( ). Mean serum albumin levels were higher in the glutamine-supplemented group. Conclusions. This preclinical study showed that oral supplementation of glutamine may provide ascites-reducing activity in pancreatic cancer patients with PC, via a cell-mediated immunity-independent mechanism. 1. Introduction Peritoneal carcinomatosis (PC) is well established as a terminal feature of advanced primary or secondary neoplasms involving the peritoneum. PC is a challenging complication associated with a poor prognosis and limited treatment options [1]. Locally advanced pancreatic cancer is one of the most common diseases causing PC and subsequent ascites formation. Terminal stage cancer patients with PC have an estimated median survival of 3–6 months [2]. At this terminal stage, quality of life, rather than the prolonging of survival, is considered the most crucial issue in palliative care. Nevertheless, the importance of life-prolonging palliative care is gaining recognition in the new era of cancer management. Because PC-associated ascites develops due to hydrostatic pressure factors rather than osmotic factors, the current management of the condition includes abdominal paracentesis, diuretics administration, and salt restriction. Nutrition support represents an alternative strategy to improve the general well-being after management for ascites. However, the value of nutrition support in patients with PC remains controversial with inconclusive survival benefits [3] and concerns that it may accelerate tumor growth [4, 5]. The pathogenesis of ascites formation in PC is unclear. It is thought to be a correlation between endothelial cells, angiogenesis, and
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