South Clin Ist Euras. 2016; 27(1): 37-41 | DOI: 10.5505/jkartaltr.2016.76736

The Effect of Oral Glutamine in the Prevention of Radiotherapy Related Esophagitis and Weight Loss in Lung Cancer Patients

Þule Karabulut Gül¹, Ahmet Fatih Oruç¹, Ramazan Atalay¹, Berrin Benli Yavuz², Duygu Gedik¹, Atýnç Aksu^1
1Kartal Training And Research Hospýtal
²Medeniyet Universty

INTRODUCTION: At this study, the effect of oral glutamine usage in the prevention of acute esphagitis and weight loss in lung cancer patients receiving radiotherapy (RT) was evaluated.
METHODS: The study included 88 patients. Results were evaluated retrospectively. Glutamine dose was 30 g daily (10 g/8 hours) during thoracic RT and for 2 weeks after RT. Once-daily 1.8–2Gy RT with one fraction was used, and 60–64 Gy RT was performed with 5 fractions of weekly treatment. Patients’ weight, body mass index (BMI) and esophagitis levels were evaluated weekly.
RESULTS: Glutamine was well tolerated by all the patients. Mean esophagus RT doses were 15.56 (12–26) Gy. No dysphagia was observed in 35 patients (39.8%), but 53 (60.2%) were found to have dysphagia. Grade 3 and Grade 4 dysphagia was not observed. Weight loss was not observed in 17 (19.3%) patients. Weight loss was observed in 20 (22.7%) patients, while weight gain was observed in 51 (58%) patients. In 19 (95%) of 20 patients with weight loss, dysphagia was present. In 34 of 68 patients who didn’t have weight loss, dysphagia was present (p=0.001). Esophagitis was detected less in the patient groups that received no more than esophagus dose of 20 Gy, with peripheral localized tumors, and patient groups that received 4 or fewer chemotherapy treatments (p=0.002).
DISCUSSION AND CONCLUSION: Oral glutamine usage is decreasing the severity and frequency of esophagitis in patients receiving RT for lung cancer and is helpful for the prevention of weight loss.

Keywords: Lung cancer, weight loss, oral glutamine, radiation esophagitis.

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Akciðer Kanserli Hastalarda Radyasyona Baðlý Özefajit ve Kilo Kaybýnýn Önlenmesinde Oral Glutaminin Etkisi

Þule Karabulut Gül¹, Ahmet Fatih Oruç¹, Ramazan Atalay¹, Berrin Benli Yavuz², Duygu Gedik¹, Atýnç Aksu^1
1Dr. Lütfi Kýrdar Kartal Eðitim Ve Araþtýrma Hastanesi
²Medeniyet Üniversitesi

GÝRÝÞ ve AMAÇ: Bu çalýþmada, akciðer kanseri nedeni ile radyoterapi (RT) uygulanan hastalarda akut özefajit sýklýðýnýn ve þiddetinin azaltýlmasý ve kilo kaybýnýn önlenmesinde oral glutaminin etkisi deðerlendirildi.
YÖNTEM ve GEREÇLER: Çalýþmaya 88 hasta alýndý. Hastalarýn sonuçlarý geriye dönük olarak deðerlendirildi. Glutamin torasik RT boyunca ve sonrasýndaki iki hafta boyunca günde 30 gr (10 gr/8 saat) verildi. Günlük 1.8–2 Gy doz þemasý ile, her gün tek fraksiyon, haftada beþ fraksiyon tedavi ile 60–64 Gy RT uygulandý. Hastalarýn kilo, vücut kitle indeksi (VKÝ) ve özefajit durumlarý haftalýk olarak deðerlendirildi.
BULGULAR: Hastalarýn tümünde glutamin iyi tolere edildi. Özefagus dozu ortalama 19.56 (12–26) Gy idi. Hastalarýn 35’inde (%39.8) disfaji geliþmezken, 53’ünde (%60.2) disfaji geliþti. Grad 3 ve 4 disfaji gözlenmedi. Hastalarýn 17’sinde (%19.3) kilo kaybý gözlenmedi. Yirmi hastada (%22.7) kilo kaybý varken, 51’inde (%58) kilo artýþý tespit edildi. Kilo kaybý olan 20 hastanýn 19’unda (%95) disfaji geliþti. Kilo kaybý olmayan 68 hastanýn 34’ünde disfaji mevcuttu (p=0.001). Özefagus dozu 20 Gy altýnda olan hasta grubunda, periferik yerleþimli tümörlerde ve dört kür ve altý kemoterapi alan gruplarda daha az özefajit tespit edildi (p=0.002).
TARTIÞMA ve SONUÇ: Akciðer kanseri nedeniyle RT ile tedavi edilen hastalarda, oral glutamin kullanýmý radyasyona baðlý akut özefajit þiddetini ve sýklýðýný azaltmakta ve kilo kaybýnýn önlenmesine yardýmcý olmaktadýr.

Anahtar Kelimeler: Akciðer kanseri, kilo kaybý, oral glutamin, radyasyon özefajiti.

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