1620 - Weight loss despite oral glutamine supplementation predicts poor prognosis in locally advanced non-small cell lung cancer patients treated with conc...
|Date||28 September 2012|
|Event||ESMO Congress 2012|
|Topics|| Supportive Care
Non-Small-Cell Lung Cancer, Locally Advanced
C. Parlak1, S. Topuk2, O. Ozyilkan3, E. Topkan2
In this retrospective study, we investigated potential impact of weight change according to oral glutamine supplementation (GLT) on survival in patients with stage IIIB non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy.Materials and methods
Of the 142 patient evaluated retrospectively, 84 received GLT (GLT+), and 58 refused GLT intake (GLT-) and analyzed as control group. GLT was given at a daily dose of 30 g in powder form mixed with fruit juices. All patients received thoracic radiotherapy (TRT) to a total dose of 60-66 Gy (2Gy/Fx) concurrently with 2 cycles of cisplatin-based chemotherapy.Results
During CRT, 76 (53.5) cases lost weight while remaining cases retained or gained weight. Weight loss in GLT- group (74.1%) was more frequent than GLT+ group (39.3%) (p < 0.001). Although not statistically significant, GLT+ cases had superior overall survival than GLT- ones (21.8 vs 19.8 m; p = 0.068). Cases that retained or gained weight during CRT had longer overall survival than those with weight loss (25.6 vs. 15.4 months, p < 0.001). Comparative survival analyzes according to weight change with respect to GLT supplementation (Table 1) revealed cases in GLT+ group that retained or gained weight had the best outcome compared to the others. Bonferoni correction of two groups that retained of gained weight (p must be <0.0084) revealed the preservation of statistical significance for the survival advantage in GLT+ group (21.7 m vs. not reached yet; p = 0.0041).
Table: 1620 Survival results according to glutamine supplementation (GLT) and wieght loss (WL)
|GLT- and KK+||GLT- and KK-||GLT+ and KK+||GLT+ and KK-||P-value|
|Median OS Months) (95%CI)||15.7 (11.8-19.6)||21,7 (12.1-31.3)||13.5 (9.8-17.2)||Not reached yet||<0.001|
Results of this study demonstrated that GLT supplementation during CRT could prevent weight loss, yielding a better survival outcome in locally advanced NSCLC. Moreover, weight loss indicates poor prognosis irrespective of GLT use, and no long term survivors in GLT- group with weight loss suggests GLT resistance as a potentially poor prognostic factor, which warrants to be verified by further studies with larger cohorts.Disclosure
All authors have declared no conflicts of interest.