AB 15. The role of glutamine in prevention and in the treatment of radiation esophagitis, in the treatment of lung cancer with radiotherapy and chemotherapy
Abstract

AB 15. The role of glutamine in prevention and in the treatment of radiation esophagitis, in the treatment of lung cancer with radiotherapy and chemotherapy

Styliani Stylianidou, Spyridon Domoxoudis, Konstantinos Kyratzopoulos, Ioannis Tzitzikas, Kyriaki Pistevou-Gompaki

Department of Radiotherapy-Oncology, University General Hospital “AHEPA”, Aristotle University of Thessaloniki, Thessaloniki, Greece


Background: The Lung cancer is the most frequent cancer in the world, such as the most frequent cause for death of cancer. Treatment as chemotherapy and radiotherapy are increasing the overall survival. Toxicity and side effects during the treatment, some times, are intensive and have affected in the quality of life of the patients. Very important is the role at glutamine in the per os prevention and the treatment for after irradiation esophagitis. The protective effect of glutamine in the patients with lung cancer which are treated with radiotherapy or/and chemotherapy.
Patients and methods: A total of 150 patients with lung cancer were treated with radiotherapy in the year 2011, in the radiation department of U.G.H.Th.AHEPA. Most of them were treated with chemotherapy before or/and during the period of radiotherapy. The total radiation dose was 55-60Gy in the tumor mass and 44Gy in the mediastinum. The patients received 3D Conformal radiotherapy with linear accelerator with Multilief collimator, after CT simulator. One week before radiotherapy in 110 patients was given glutamine 30 gr/day per os. They continued during therapy (~6 weeks) such as ~ one month after the end of fractions. 40 patients refused to take glutamine per os or/and not tolerated treatment with glutamine. All of them concluded the fractions of RT. They were under observation for the toxicitim of the side of esophagus, pain and dysphagia. Concurrently we have give instructions for diet and treatment with antimycotic drugs.
Results: In the weekly follow-up, all the patients which have taken glutamine, before, during and after the end of therapy (radio ± chemotherapy) presented with mild toxicity: esophagitis Grade I, mild pain, dysphagia Grade O-I. The symptoms relieved two weeks after the end of RT fractions. A total of 25 patients who have not take glutamine presented with esophagitis Grade II. After 20 fractions of RT in these patients presented loss of weight loss of apetit, fatigue, myalgia, nausea. The symptoms relieved 1½ month after the end of RT fractions. A total of 15 patients who have not take glutamine, presented esophagitis Grade III with dysphagia Grade III and causalgia in esophagus. The patients presented loss of weight (~10 kg), myalgia and intensive fatigue. The symptoms retreated two months after the end of radiotherapy.
Conclusions: Its acceptable the positive effect of glutamine, per os, in the prevention and the treatment of toxicity due to radio-chemotherapy in patients with lung cancer. Decrease in minimal esophagitis after irradiation. So, 3D Conformal radiotherapy (in high doses) or/and chemotherapy, gives the best results increasing the overall survival and improve the quality of life.

Cite this abstract as: Stylianidou S, Domoxoudis S, Kyratzopoulos K, Tzitzikas I, Pistevou-Gompaki K. The role of glutamine in prevention and in the treatment of radiation esophagitis, in the treatment of lung cancer with radiotherapy and chemotherapy. J Thorac Dis 2012;4(S1):AB15. DOI: 10.3978/ j.issn.2072-1439.2012.s015

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