Effect of Glutamine Supplementation on Chemoradiotherapy-induced Mucositis in Patients with Head and Neck Cancer

In head and neck cancer, almost all patients treated with chemoradiotherapy suffer from oral mucositis. But, a standard treatment for chemoradiotherapy-induced oral mucositis has not been established. It is considered that the creation of reactive oxygen species (ROS) caused by radiation and anticancer drugs is related to the mechanism that causes oral mucositis. Recently, it was reported that glutamine, an antioxidant, can reduce oral mucositis induced by chemoradiotherapy. Therefore, in the present study we examined the effects of glutamine supplementation on oral mucositis in head and neck cancer patients receiving chemoradiotherapy. Of the patients with head and neck cancer who received chemoradiotherapy or radiotherapy, we compared 6 patients receiving glutamine supplementation and 7 patients not receiving it. The patients receiving glutamine supplementation showed a reduction in the grade of oral mucositis with grade 4 never being reached, and both intake and the type of food were maintained. There was a significant elevation of the C-reactive protein (CRP) score in patients not receiving glutamine supplementation compared with those who received it (2.43 vs. 0.77, P<0.05). This result suggested that glutamine supplementation had therapeutic effects on oral mucositis induced by chemoradiotherapy.