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
Session Publication Only
Topics Supportive Care
Non-Small-Cell Lung Cancer, Locally Advanced
Presenter Cem Parlak
Authors C. Parlak1, S. Topuk2, O. Ozyilkan3, E. Topkan2
  • 1Baskent University Adana Medical Faculty, 01120 - Adana/TR
  • 2Department Of Radiation Oncology, Baskent University Adana Medical Faculty, 01120 - Adana/TR
  • 3Medical Oncology, Baskent University Faculty of MedicineAdana Uygulama Ve Arastirma Mer., TR-01120 - Adana/TR

Abstract

Background

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
1-year OS 65.1 93.3 60.6 98.0
2-year OS 12.1 44.9 3.8 58.3

Conclusion

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.