Role of Oral Glutamine in Prevention and Treatment of Oral Mucositis in Head and Neck Cancer Patients Receiving Chemoradiation

Abstract

Purpose: To evaluate the efficiency of glutamine in the prevention & treatment of mucositis in head and neck cancer patients undergoing chemoradiation. Material and Methods: Forty patients of histologically proven head and neck carcinomas undergoing chemoradiation with Conventional Radiation on telecobalt and concurrent Cisplatin were randomised into 2 groups. The study group received oral glutamine solution 2 hours prior to undergoing radiotherapy on all days of treatment. The severity and duration of mucositis were recorded once every week using WHO and RTOG grading system for all patients undergoing treatment. Results: Glutamine lead to a delay in the onset of mucositis. The overall incidence of grade mucositis was significantly low in glutamine arm (22% vs 55%, p= 0.006). On weekly assessments, the incidence of grade mucositis in study arm compared to the control was 0 vs 30%, p=0.02 at 4 weeks, 15.8 vs 45%, p= 0.038 at 5 weeks and 22 vs 70%, p=0.001 at 6 weeks. However, there was no statistically significant difference in the incidence of grade 1 and 2 mucositis in both arms. Conclusion: Use of oral glutamine reduces the incidence and duration of oral mucositis and hence helpful in the prevention and treatment of oral mucositis with good compliance and further result in good locoregional control of the disease.