Oral glutamine supplements reduce concurrent chemoradiotherapy-induced esophagitis in patients with advanced non-small cell lung cancer

Abstract

Background: Complications related to concurrent chemoradiotherapy (CCRT) such as acute radiation-induced esophagitis (ARIE) may cause significant morbidity and unplanned treatment delays in patients with advanced non-small cell lung cancer (NSCLC). We designed a prospective randomized study to assess the impact of glutamine (GLN) supplementation in preventing CCRT-induced toxicities of advanced NSCLC patients. Methods: From September 2014 to September 2015, 60 patients diagnosed with NSCLC were included to the study. Thirty patients (50%) received prophylactic powdered GLN orally at a dose of 10 g/8 h. The prescribed radiation dose to the planning target volume was 30 Gy in 2-Gy fractions. The endpoints were radiation-induced esophagitis, mucositis, body weight loss, overall survival and progression-free survival. Results: The 60 patients with NSCLC included 42 men and 18 women with a mean age ± standard deviation of 60.3 years ± 18.2 (range, 44–78 years). At a median follow-up of 26.4 months (range 10.4–32.2), all patients tolerated GLN well. A administration of GLN was associated with a decrease in the incidence of grade 2 or 3 ARIE (6.7% vs 53.4% for Gln+ vs Gln-; P = .004). GLN supplementation appeared to significantly delay ARIE onset for 5.8 days (18.2 days vs 12.4 days; P = .027) and reduced incidence of weight loss (20% vs 73.3%; P = .01). Discussion: Our study suggests a beneficial effect of oral glutamine supplementation for the prevention from radiation-induced injury and body weight loss in advanced NSCLC patients who receiving CCRT.

RETRACTED: Huaier extract suppresses non‐small cell lung cancer progression through activating NLRP3‐dependent pyroptosis

“…Non‐small cell lung cancer (NSCLC) is one of the most malignant tumors with the fastest growth rate of morbidity and mortality in the world (Balata et al, 2019; Chang et al, 2019). The primary treatment of NSCLC includes surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy (Dafni et al, 2019; Wan et al, 2019).…”

Oral Glutamine May Have No Clinical Benefits to Prevent Radiation-Induced Oral Mucositis in Adult Patients With Head and Neck Cancer: A Meta-Analysis of Randomized Controlled Trials

“…Moreover, glutamine may play an important role in glutathione synthesis, which can decrease the oxidative stress (42). Several clinical studies (43,44) also established the effects of oral glutamine in preventing and treating cancer treatment related injuries. Chang and colleagues (43) found a beneficial effect of oral glutamine supplementation for the prevention from radiation-induced esophagitis in advanced patients with advanced non-small cell lung cancer who undergoing concurrent chemoradiotherapy.…”

“…Several clinical studies (43,44) also established the effects of oral glutamine in preventing and treating cancer treatment related injuries. Chang and colleagues (43) found a beneficial effect of oral glutamine supplementation for the prevention from radiation-induced esophagitis in advanced patients with advanced non-small cell lung cancer who undergoing concurrent chemoradiotherapy. Randomized trial performed by Eda et al (44) suggested that enteral glutamine minimizes radiation induced dermatitis in breast cancer patients.…”

Formulation Development of Mucoadhesive Microparticle-Laden Gels for Oral Mucositis: An In Vitro and In Vivo Study

“…In general, the etiology of chemotherapy-induced mucositis can be divided into two main causes. One primary cause is mucosal inflammation due to the destruction of the cells caused by reactive oxygen species (superoxide or hydroxy radicals) generated by anticancer agents [ 4 , 5 ]. Cells in the oral mucosa also will be exposed to metabolic damage as a result of their uptake of anticancer agents, ends up in blocking healthy oral mucosal cell turnover.…”