title: The effects of oral glutamine on clinical and survival outcomes of non-small cell lung cancer patients treated with chemoradiotherapy.
abstract: To assess the efficacy of oral glutamine (Gln) supplementation on clinical and survival outcomes of patients with locally advanced non-small cell lung cancer (LA-NSCLC).
  
  
  
  Between 2010 and 2014, 122 stage III NSCLC patients were retrospectively analyzed. All patients received curative intent chemoradiotherapy (CRT). Prophylactic oral Gln powder was applied at a dose of 10 g tid. Effect of oral Gln supplementation in the prevention of severe (≥grade 2-3) acute radiation-induced esophagitis (ARE) and weight loss, and their relation with overall survival (OS) and disease-free survival (DFS) was measured.
  
  
  
  Median follow-up was 13.14 months (range; 1.97-55.36). Fifty-six (46%) patients had received oral Gln. Severe ARE was significantly lower in Gln-supplemented group (30% vs 70%; p = 0.002). Gln-free patients demonstrated a higher weight loss (p = 0.0001). In multivariate analysis hemoglobin (hb) level (<12 g/dL; p = 0.01) and nodal stage (N3; p = 0.01) were poor prognostic factors that affect OS; Weight loss (p = 0.06) and Gln-free (p = 0.05) reached nearly significant levels that poorly affect OS. Similarly, nodal stage (N3, p = 0.014) and Gln-free (p = 0.035) were poor prognostic factors that affect DFS. Weight loss (≥2%, p = 0.06) and hb level (<12 g/dL, p = 0.07) reached borderline significance that poorly affect DFS. Nodal stage (N3) was the only poor prognostic factor that affect OS and DFS in univariate analysis (p = 0.01, p = 0.009; respectively).
  
  
  
  Oral Gln supplementation significantly reduces grade 2-3 esophagitis and weight loss and also no negative impact on tumor control and survival outcomes in patients with LA-NSCLC.
authors.affiliation: Necmettin Erbakan University Meram Medicine School, Department of Radiation Oncology, Akyokus Mevkii, 42090, Konya, Turkey. Electronic address: drgulgun@yahoo.com.
authors.forename: Kanyilmaz
authors.initials: K
authors.lastname: Gul
authors.affiliation: Necmettin Erbakan University Meram Medicine School, Department of Radiation Oncology, Akyokus Mevkii, 42090, Konya, Turkey.
authors.forename: Koc
authors.initials: K
authors.lastname: Mehmet
authors.affiliation: Necmettin Erbakan University Meram Medicine School, Department of Radiation Oncology, Akyokus Mevkii, 42090, Konya, Turkey.
authors.forename: Aktan
authors.initials: A
authors.lastname: Meryem
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000178:diet therapy* / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy / Q000009:adverse effects*; D003131:Combined Modality Therapy / Q000009:adverse effects; D019587:Dietary Supplements / Q000009:adverse effects; D004941:Esophagitis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D005973:Glutamine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000178:diet therapy* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D011832:Radiation Injuries / Q000503:physiopathology / Q000517:prevention & control*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016019:Survival Analysis; D047368:Tumor Burden / Q000528:radiation effects; D015431:Weight Loss / Q000528:radiation effects
chemical_list: D005973:Glutamine
keywords: Acute radiation-induced esophagitis; Glutamine; Survival outcomes; Weight loss