PURPOSE: To assess the usefulness of oral glutamine to prevent radiochemotherapy-induced esophagitis in patients with lung cancer, and to determine the dosimetric parameter predictive of esophagitis. METHODS AND MATERIALS: Seventy-five patients were enrolled; 34.7% received sequential radiochemotherapy, and 65.3% received concomitant radiochemotherapy. Every patient received prophylactic glutamine powder in doses of 10 g/8 h. Prescribed radiation doses were 45-50 Gy to planning target volume (PTV)1 (gross tumor volume plus wide margins) and 65-70 Gy to PTV2 (reduced margins). The primary endpoint was the incidence of Grade 2 or greater acute esophagitis. RESULTS: No patient experienced glutamine intolerance or glutamine-related toxicity. Seventy-three percent of patients who received sequential chemotherapy and 49% of those who received concomitant chemotherapy did not present any form of esophagitis. V50 was the dosimetric parameter with better correlation between esophagitis and its duration. A V50 of <or=30% had a 22% risk of esophagitis Grade >or=2, which increased to 71% with a V50 of >30% (p = 0.0009). CONCLUSIONS: The use of oral glutamine may have an important role in the prevention of esophageal complications of concomitant radiochemotherapy in lung cancer patients. However, randomized trials are needed to corroborate that effect. V50 is the dosimetric parameter with better correlation with esophagitis grade and duration.
PURPOSE: To assess the usefulness of oral glutamine to prevent radiochemotherapy-induced esophagitis in patients with lung cancer, and to determine the dosimetric parameter predictive of esophagitis. METHODS AND MATERIALS: Seventy-five patients were enrolled; 34.7% received sequential radiochemotherapy, and 65.3% received concomitant radiochemotherapy. Every patient received prophylactic glutamine powder in doses of 10 g/8 h. Prescribed radiation doses were 45-50 Gy to planning target volume (PTV)1 (gross tumor volume plus wide margins) and 65-70 Gy to PTV2 (reduced margins). The primary endpoint was the incidence of Grade 2 or greater acute esophagitis. RESULTS: No patient experienced glutamine intolerance or glutamine-related toxicity. Seventy-three percent of patients who received sequential chemotherapy and 49% of those who received concomitant chemotherapy did not present any form of esophagitis. V50 was the dosimetric parameter with better correlation between esophagitis and its duration. A V50 of <or=30% had a 22% risk of esophagitis Grade >or=2, which increased to 71% with a V50 of >30% (p = 0.0009). CONCLUSIONS: The use of oral glutamine may have an important role in the prevention of esophageal complications of concomitant radiochemotherapy in lung cancerpatients. However, randomized trials are needed to corroborate that effect. V50 is the dosimetric parameter with better correlation with esophagitis grade and duration.
Authors: Peter Paximadis; Matthew Schipper; Martha Matuszak; Mary Feng; Shruti Jolly; Thomas Boike; Inga Grills; Larry Kestin; Benjamin Movsas; Kent Griffith; Gregory Gustafson; Jean Moran; Teamour Nurushev; Jeffrey Radawski; Lori Pierce; James Hayman Journal: Pract Radiat Oncol Date: 2017-07-19
Authors: Joanne M Bowen; Rachel J Gibson; Janet K Coller; Nicole Blijlevens; Paolo Bossi; Noor Al-Dasooqi; Emma H Bateman; Karen Chiang; Charlotte de Mooij; Bronwen Mayo; Andrea M Stringer; Wim Tissing; Hannah R Wardill; Ysabella Z A van Sebille; Vinisha Ranna; Anusha Vaddi; Dorothy Mk Keefe; Rajesh V Lalla; Karis Kin Fong Cheng; Sharon Elad Journal: Support Care Cancer Date: 2019-07-08 Impact factor: 3.603
Authors: Rachel J Gibson; Dorothy M K Keefe; Rajesh V Lalla; Emma Bateman; Nicole Blijlevens; Margot Fijlstra; Emily E King; Andrea M Stringer; Walter J F M van der Velden; Roger Yazbeck; Sharon Elad; Joanne M Bowen Journal: Support Care Cancer Date: 2012-11-10 Impact factor: 3.603