Leung, H.W., & Chan, A.L. (2016). Glutamine in alleviation of radiation-induced severe oral mucositis: A meta-analysis. Nutrition and Cancer, 68, 734–742. 

DOI Link

Purpose

STUDY PURPOSE: To assess the effectiveness of glutamine to treat severe mucositis induced by radiation therapy in patients with head and neck cancer

TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: Electronic searches of PubMed (1990–January 2015), Embase (1990–January 2015), and the Cochrane Library (2013, issue 2) were used. 
 
INCLUSION CRITERIA: Randomized controlled trials of glutamine to alleviate oral mucositis (OM) in patients with head and neck cancer who received radiotherapy (n = 5)
 
EXCLUSION CRITERIA: Patients who did not have OM (n = 8)

Literature Evaluated

TOTAL REFERENCES RETRIEVED = 28 
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: The grading approach outlined in the Cochrane Handbook for Systematic Reviews of Interventions and GRADES criteria for evaluation

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 5
  • TOTAL PATIENTS INCLUDED IN REVIEW = 234 patients with head and neck cancer
  • SAMPLE RANGE ACROSS STUDIES: 8–61 patients
  • KEY SAMPLE CHARACTERISTICS: Patients receiving radiation therapy for head and neck cancer

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

APPLICATIONS: Elder care

Results

Glutamine treatment had statistically significant benefits: It (a) reduced the risk and severity of OM (grade IV) (RR = 0.17, 95% confidence interval [0.06, 0.47]) and (b) shortened the duration of OM by 2–3 days. The studies reviewed had a low risk of overall bias.

Conclusions

The protective effects of glutamine for radiation and chemotherapy-induced mucositis are promising. Glutamine or alanyl-glutamine accelerated the mucosal recovery through increasing mucosal tissue glutathione stores, reducing inflammatory parameters and speeding re-epithelization.

Limitations

  • Limited search
  • Limited number of studies included
  • Low sample sizes

Nursing Implications

Large prospective, comprehensive clinical trials are needed to investigate the effectiveness of glutamine in the prevention of OM induced by radiation therapy or chemoradiotherapy.

Legacy ID

5948