Prevention of Oral Mucositis Secondary to Antineoplastic Treatments in Head and Neck Cancer by Supplementation With Oral Glutamine

Abstract

oral glutamine in patients receiving cancer treatments for HNC prevents the incidence of oral mucositis and odynophagia, and decreases treatment interruptions and the use of analgesia and nasogastric tube.

Glutamine for prevention and alleviation of radiation‐induced oral mucositis in patients with head and neck squamous cell cancer: Systematic review and meta‐analysis of controlled trials

“…Thus far, there are no established guidelines for prevention of OM induced by RT and CRT in HNSCC patients 12–14 . Recently, glutamine has been investigated as a potential therapeutic candidate to prevent and alleviate radiation‐induced OM in HNSCC patients; however, the results were inconsistent 23–33 . Despite the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) clinical guidelines recommending the use of oral glutamine to prevent OM in HNSCC patients undergoing CRT, 13 the use of glutamine is not yet currently approved by the U.S. Food and Drug Administration (FDA) or any other drug‐regulatory bodies.…”

“…The included trials had some variations in patient characteristics and the drug doses and applications which could have influenced the pooled outcomes. Moreover, one of the included studies was nonrandomized 29 ; however, this shortcoming was offset by the large sample size of 262 patients to attain a high statistical power of 90%.…”

“…Only two studies 27,28 had an overall low risk of bias in all domains. One study 29 was nonrandomized and hence the randomization sequence generation and allocation concealment domains were judged as high risk. Several studies 23,25,26,32,33 did not have accessible study protocol and hence we judged the selective reporting domain as high risk.…”

“…Several clinical trials have endeavored to scrutinize the efficacy of glutamine in the prevention of OM in HNSCC patients receiving RT or CRT 23–33 . However, the results were inconsistent and methodologically limited by small sample size.…”

“…Several clinical trials have endeavored to scrutinize the efficacy of glutamine in the prevention of OM in HNSCC patients receiving RT or CRT. [23][24][25][26][27][28][29][30][31][32][33] However, the results were inconsistent and methodologically limited by small sample size. Thus, there is a need to amass evidence from clinical trials to draw solid conclusions concerning the efficacy of glutamine in preventing or attenuating radiation-induced OM in HNSCC patients.…”