Oral Glutamine Supplementation Reduces Radiotherapyinduced Esophagitis in Lung Cancer Patients

Abstract

<b>Background:</b> The purpose of this study was to assess the the efficacy of oral glutamine (GLN) in preventionof acute radiation-induced esophagitis in patients with lung cancer and determine the predictive role of clinicaland dosimetric parameters. Materials and <br/><b>Methods</b>: Thirty-two patients diagnosed with lung cancer werestudied prospectively. Sixteen patients (50%) received prophylactic powdered GLN orally in doses of 10g/8h.Patients were treated 2 Gy per fraction daily, 5 days a week. We evaluated the grading of esophagitis daily atthe end of each fraction of each treatment day until a cumulative dose of 50 Gy was reached. The primary endpoint was radiation-induced esophagitis. <br/><b>Results</b>: All patients tolerated GLN well. Toxicity grade, weight loss,serum cytokine levels and esophageal transit times exhibited statistically significant improvement in the GLNreceiving group. GLN suppressed the inflammation related to the disease and treatment and reduced toxicitywith statistical significance. <br/><b>Conclusions</b>: This study suggests a benefical role of oral GLN use in preventionand/or delay of radiation-induced esophagitis, in terms of esophageal transit time and serum immunologicalparameters, as well as weight loss.