The efficacy of oral glutamine in prevention of acute radiotherapy-induced esophagitis in the patients with lung cancer

AimThe aim of this study is to find out the efficacy of oral glutamine in the prevention of acute radiotherapy-induced esophagitis in the patients with lung cancer, who are treated with thoracic radiotherapy.Material and Method46 patients with lung cancer, who were treated and kept under control between January 2008-January 2010 are included in the study by the Department of Radiation Oncology, Faculty of Medicine, Dicle University. The patients included in the study are divided into two groups. 21 patients in the first group was given prophylactic oral powder glutamine (daily 30gram). But the patients in the second group weren?t given oral glutamin. The patients were compared according to age, gender, stage, histopathologic type, treatment choice, irradiated esophagus length and location of tumour. Two groups were assessed in terms of acute radiotherapy-induced esophagitis.FindingsTotally, 46 patients were included in the study. There were 21 patients in group 1 (45,7 %), 25 patients in group 2 (54,3 %). No significant difference was observed statistically between two groups in terms of age, gender, stage, histopathologic type, treatment choice, received radiation doses, esophagus length in RT field and location of tumour(p> 0,05). In the first group that was given glutamine, 61,9 % (13 patients) of our patients were grade 1 where as in the second group that weren?t given glutamine, 8,0 % (2 patients) of the patients were grade 1. In the first group 4,8 % (1 patient) of patients was grade 3 esophagitis, but in the second group 44,0 % (11 patients) of patients were grade 3 esophagitis. A significant difference was observed statistically between the glutamine-supplemented group (first group) and the glutamine-free group (second group) (p<0,0001). There wasn?t any significant difference between the grades of acute radiotherapy-induced esophagitis and treatment choice, histopathologic type, received RT doses, irradiated esophagus length, indication of subtype of Nonsmall cell lung cancer (NSCLCa) diagnosed patients (p> 0,05).ResultIn our retrospective randomised experimental study, we have determined that in the patients with lung cancer, who are treated with thoracal radiotheraphy, the severity of acute radiotherapy-induced esophagitis may be decreased with oral glutamine. In conclusion, the results of this study suggest a beneficial role for oral glutamine use in prevention of the severity of acute radiotherapy-induced esophagitis. But when we compare similiar trials in the world with our study, we think that prospective randomized clinic trials with larger patient populations should be done to be able to reach this result.