Assessment of toxicity profile among patients receiving concurrent chemoradiotherapy in head and neck cancer patients with or without glutamine supplements

Abstract

Introduction: Chemoradiation is commonly used curative treatment option for many forms of thecancer and produce synergistic effects than chemotherapy or radiation, per se. Objective: This study aims at assessing and comparing the toxicity profile and treatment breaks in patients receiving concurrent chemoradiation with 3D-Conformal Radiotherapy with or without glutamine supplements in head &neck cancers. Methods: 80 patients diagnosed with squamous cell carcinoma of the head and neck who were treated with 3D-Conformal Radiotherapy in the as a prospective non-randomized double-arm observational study. 40 patients who received glutamine supplements and 40 patients who didn’t receive glutamine supplements were reviewed weekly once for assessment of toxicity profile. Results: Out of the 80 patients, 64 patients were male and 16 female. Mean age was 54 years (range 13-74 years). 40 patients received glutamine supplements and 40 patients didn’t receive glutamine supplements. The mean maximum grade of oral mu-cositis, dysphagia, skin reactions was less severe in the patients receiving glutamine compared to the patients not receiving glutamine ((p=0.0001).7.5% of patients who received glutamine supplements developed grade 3 skin reactions compared to 20% of patients who didn’t receive glutamine supplements. 7.5% in the glutamine arm had treatment breaks with a range of 2-5 days. 32.5% in the control arm had treatment breaks with a range of 3-10 days. Conclusions: Glutamine supplementation in head and neck cancer patients receiving concurrent chemoradiotherapy may delay the onset of mucositis reactions, skin reactions, dysphagia and also the progression of the mucositis reactions, skin reactions, and dysphagia.