Journal of Clinical Epigenetics Open Access

The preventive role of intravenous L-alanyl L-glutamine in reducing the incidence of oral mucositis in head and neck cancer patients receiving radiotherapy with or without chemotherapy

2^nd International Congress on Epigenetics & Chromatin

November 06-08, 2017 | Frankfurt, Germany

Nesreen Mohamed Sabry Afifi Mattar, Amany M El Feky and Ashraf O Barakat

Tanta University Hospitals, Egypt

Scientific Tracks Abstracts: J Clin Epigenet

Abstract:

Statement of the Problem: Patients with H&N cancer who receive RTH with or without chemotherapy complain always from mucositis this study is a prospective comparative phase 2 aimed to assess the role of intravenous L-alanyl L-Glutamine in reducing the rate of oral mucositis for squamous head and neck cancer patients receiving radiotherapy with or without concurrent chemotherapy. Methodology& Theoretical Orientation: From September 2014 to September 2016, 100 H&N cancer patients were treated with radiotherapy or combined chemo-radiation at our oncology department. Patients were randomized in 1:1 ratio into group A (n=50 patients) treated by radiotherapy or concurrent chemo-radiotherapy and group B (n=50 patients) to receive same treatment in addition to intravenous glutamine. The investigational drug was infused daily at dose of 0.3-0.4 g/kg diluted in NS and administered at rate of 0.1 g/Kg/hr. All patients received total dose of 65-70 Gy using LINAC 6 MV photon beam supplemented with electron beam when needed. For concurrent chemotherapy, cisplatin (40 mg/m2) was administered weekly. Mucositis was assessed by WHO grading system. Results: A significantly higher incidence of mucositis was reported in 46% of group A compared with10% in group B. Group B had significantly longer period free from mucositis in comparison to group A with median time (12 weeks vs. 8 weeks). A significant lower rate of radiotherapy interruption was reported in group B compared to group A (50% vs. 14%). More Patients needed hospitalization in group A (20%) vs. (5%) in group B. No adverse effects were observed in relation to glutamine. Conclusion & Significance: IV L-alanyl L-Glutamine may be an effective measure to lower incidence or prevention of oral mucositis in H&N cancer patients treated by RTH or combined chemo RTH. Recent Publication 1. Papanikolopoulou A, Syrigos KN and Nikolaos Drakoulis (2015) The role of glutamine supplementation in thoracic and upper aerodigestive malignancies. Nutrition and Cancer. 67(2):231-237. 2. Gul K, Muge A, Taner A, et al (2015) Oral glutamine supplementation reduces radiotherapy- induced esophagitis in lung cancer patients. Asian Pac J Cancer Prev. 16(1):53-58. 3. Tsujimoto T, Yamamoto Y, Wasa M, et al (2015) L-glutamine decreases the severity of mucositis induced by chemoradiotherapy in patients with locally advanced head and neck cancer: a double-blind, randomized, placebocontrolled trial. Oncol Rep. 33(1):33-39. 4. Chattopadhyay S, Saha A, Azam M, et al (2014) Role of oral glutamine in alleviation and prevention of radiationinduced oral mucositis South Asian Journal of Cancer 3(1):8-12 5. Tutanc OD, Aydogan A, Akkucuk S, et al (2013) The efficacy of oral glutamine in prevention of acute radiotherapyinduced esophagitis in patients with lung cancer. Contemporary Oncology (Poznan) 17(6):520-524.

Biography :

Nesreen Mohamed Sabry Afifi Mattar is working as a Lecturer of Clinical Oncology at Tanta University Hospital. She also works as a Consultant in insurance hospital. She has an experience in teaching postgraduate students. She completed her Master’s degree on the topic “Comparative study between chemoradiation and surgery in bladder cancer” and: MD on the topic “Comparative study between RCHOP and CHOP in DLBC NHL according to biomarker mutation (bcl2, p53)”. Recently, she has published a paper on “The role of lapatinib in combination with letrozole in postmenopausal breast cancer women”.