Among patients with advanced head and neck cancer treated with chemotherapy and radiation therapy, intravenous treatment with a derivative of the amino acid glutamine may reduce the severity of oral mucositis. These results were published in the International Journal of Radiation Oncology Biology Physics.
Head and neck cancers originate in the throat, larynx (voice box), pharynx, salivary glands, or oral cavity (lip, mouth, tongue). Most head and neck cancers involve squamous cells, which are cells that line the mouth, throat, or other structures.
Oral mucositis refers to inflammation of the oral mucosa (lining of the mouth) that results from chemotherapy or radiation therapy. Symptoms may include redness, swelling, and ulceration. When oral mucositis is severe, patients cannot swallow food or liquid and often have to be given nutrients through a vein. In addition, oral mucositis can cause severe pain, increase the risk of infection, and may limit a patient’s ability to tolerate further treatment.
Glutamine is an amino acid that plays a role in cellular repair. To evaluate the safety and effectiveness of intravenous administration of a derivative of glutamine-L-alanyl-L-glutamine-researchers in Argentina conducted a clinical trial among 29 patients with advanced head and neck cancer. Half the patients received intravenous L-alanyl-L-glutamine and half the patients received intravenous saline (the placebo).
- Severe oral mucositis developed in 14% of patients treated with L-alanyl-L-glutamine and 67% of patients treated with the placebo.
- A feeding tube was required by 14% of patients treated with L-alanyl-L-glutamine and 60% of patients treated with the placebo.
- Patients treated with L-alanyl-L-glutamine reported less pain than patients treated with the placebo.
- L-alanyl-L-glutamine did not appear to produce any adverse side effects.
The researchers conclude that intravenous treatment with the glutamine derivative L-alanyl-L-glutamine may reduce the severity of oral mucositis in patients with advanced head and neck cancer.
Reference: Cerchietti LCA, Navigante AH, Lutteral MA et al. Double-Blinded, Placebo-controlled Trial on Intravenous L-alanyl-L-glutamine in the Incidence of Oral Mucositis Following Chemoradiotherapy in Patients with Head and Neck Cancer. International Journal of Radiation Oncology Biology Physics. 2006;65:1330-1337.
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