title: Role of oral glutamine in alleviation and prevention of radiation-induced oral mucositis: A prospective randomized study.
abstract: BACKGROUND
  Oral mucositis is the most frequently occurring painful and dose-limiting side-effect of radiation of the head and neck region. Few studies demonstrated that oral glutamine suspension may significantly reduce the duration and severity of objective oral mucositis during radiotherapy.
  
  
  METHODS
  A randomized, prospective single institutional case control study was performed between April 2012 and November 2012 comparing the influence of oral glutamine on radiation induced mucositis in head and neck malignancy patients. Seventy biopsy proven patients with head and neck cancer receiving primary or adjuvant radiation therapy were randomized to receive either oral glutamine suspension daily 2h before radiation in the study arm (10 g in 1000 ml of water) (n = 35) or nothing before radiation; control arm (n = 35).
  
  
  RESULTS
  Total 32 patients (91.43%) in the glutamine arm and total 34 patients (97.15%) developed mucositis. Grade 3 mucositis (14.29%) and grade 4 mucositis (2.86%) in the study arm (who received oral glutamine) were significantly less (P = 0.02 and P = 0.04, respectively) in the glutamine arm. The mean duration of grade 3 or worse mucositis (grade 3 and grade 4) was significantly less (6.6 days vs. 9.2 days) in study arm with P < 0.001. Mean time of onset of mucositis was significantly delayed in patients who took glutamine in comparison to control arm with P < 0.001.
  
  
  CONCLUSIONS
  Glutamine delays oral mucositis in the head neck cancer patients. Moreover, it reduces the frequency and duration of grade 3 and grade 4 mucositis.
authors.affiliation: Department of Radiotherapy, Medical College, Kolkata, West Bengal, India.
authors.forename: Subrata
authors.initials: S
authors.lastname: Chattopadhyay
authors.affiliation: Department of Radiotherapy, Medical College, Kolkata, West Bengal, India.
authors.forename: Aramita
authors.initials: A
authors.lastname: Saha
authors.affiliation: Department of Radiotherapy, Medical College, Kolkata, West Bengal, India.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Azam
authors.affiliation: Department of Radiotherapy, Medical College, Kolkata, West Bengal, India.
authors.forename: Anindya
authors.initials: A
authors.lastname: Mukherjee
authors.affiliation: Department of Radiotherapy, Medical College, Kolkata, West Bengal, India ; Department of Clinical Oncology, Hemalata Hospitals and Research Center, Bhubaneswar, Orissa, India.
authors.forename: Prabir Kumar
authors.initials: PK
authors.lastname: Sur
keywords: Duration; chemoradiotherapy; glutamine; head and neck; mucositis; radioprotectant; severity