Oral Glutamine for Radiation-Induced Esophagitis in Lung Cancer Patients

Oral Glutamine for Radiation-Induced Esophagitis in Lung Cancer Patients

In this retrospective randomized experimental study, Tutanc, Aydogan, Akkucuk, and colleagues enrolled 46 patients with lung cancer treated by thoracic radiotherapy between 2008 and 2010. They were divided into two groups: 21 patients received prophylactic oral glutamine (30 g per day, in powder form), and 25 patients did not receive glutamine. All underwent comparable radiotherapy regimens and were monitored for development and severity of esophagitis during treatment.

The two groups were well matched in age, gender, tumor stage, histology, radiation dose, and esophagus length in the radiation field. When outcomes were compared, the glutamine group experienced significantly less severe esophagitis: the grade of esophagitis was much lower in the glutamine-supplemented group compared to the control group according to RTOG criteria, a grading system used to measure therapy toxicity.

These findings suggest that oral glutamine may help reduce the severity of acute radiotherapy-induced esophagitis in lung cancer patients undergoing thoracic radiation. The authors propose that glutamine’s known roles in mucosal protection, anti-inflammatory effects, and tissue repair might underlie this benefit.

It’s important to note that this was a relatively small trial and that the study design was described as “retrospective randomized experimental,” which may carry limitations. Nevertheless, the magnitude of the difference is striking and provides justification for further prospective, larger trials to confirm whether glutamine should be recommended as a prophylactic adjunct during thoracic radiotherapy.

 

Reference:

Tutanc OD, Aydogan A, Akkucuk S, et al. The efficacy of oral glutamine in prevention of acute radiotherapy-induced esophagitis in patients with lung cancer. Contemp Oncol (Pozn). 2013;17(6):520‐524.