369P - Impact of glutamine supplements in altering the toxicity profile in head and neck cancer patients receiving concurrent chemoradiotherapy

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer Agents
Head and Neck Cancers
Surgical Oncology
Presenter Karthikeyan Perumal
Citation Annals of Oncology (2016) 27 (suppl_9): ix112-ix122. 10.1093/annonc/mdw587
Authors K. Perumal, P.K. Reddy, M. Potharaju
  • Radiation Oncology, Apollo Speciality Hospital, 600035 - Chennai/IN



To compare the toxicity profile and treatment breaks during concurrent chemo radiation with or without glutamine supplements in non-metastatic head and neck squamous cell carcinoma (HNSCC).


This prospective non randomized double arm observational study involved the assessment and comparison of toxicity profile in 80 HNSCC patients treated by 3D-Conformal Radiotherapy with concurrent weekly cisplatin (40mg/m2). Glutamine was administered as 10 grams of L-Glutamine mixed with 200 ml of water two times a day. All the patients were reviewed weekly for toxicity assessment and graded using RTOG Acute Radiation Morbidity Grading System. 40 (50%) received glutamine supplements.


Our patient population was characterized by 64 males (80%) and 16 females (20%) with a mean age of 54 years (range 13-74 years) with site wise distribution of carcinoma hypopharynx in 21 (26.25%) patients, carcinoma larynx in 24 (30%), carcinoma oral cavity in 22 (27.5%), carcinoma oropharynx in 10 (12.5%), and carcinoma parotid in 3 (3.75%) patients and stage wise distribution of T2N1M0 in 37 (46.25%) patients, T2N2M0 in 5 (6.25%), T3N1M0 in 26 (32.5%), T3N2M0 in 12 (15%) patients. The mean dose of radiation at the time of occurrence of mucositis was 21 Gy (without glutamine) vs. 29 Gy (with glutamine); dysphagia was 22 Gy (without glutamine) vs. 24 Gy (with glutamine); of skin reactions was 21 Gy (without glutamine) vs. 24.25 Gy (with glutamine); 7.5% had treatment breaks (with glutamine) with a range of 2-5 days vs. 32.5% (without glutamine) with a range of 3-10 days (p 


Glutamine supplementation in HNSCC delays the onset of mucositis, skin reactions, dysphagia and decrease the treatment breaks.

Clinical trial indentification

Legal entity responsible for the study



Apollo Specialty Hospital.


All authors have declared no conflicts of interest.