4. Discussion
tumor, cancers, non-small-cell lung cancer, toxicity, cancer, traumas, carcinoma, burns, postoperative sepsis, head and neck cancer, tumors
TUMOR, CANCERS, ADVERSE EVENTS, CANCER, CARCINOMA, TUMOR PROGRESSION, HEAD AND NECK CANCER, TUMORS
In this study, glutamine was administered orally to patients with locally advanced head and neck cancer throughout the course of chemoradiotherapy. Thereafter, the overall survival and progression-free survival recorded in the glutamine and placebo groups were compared. Our analysis did not reveal significant differences in these outcomes between the two groups. This finding demonstrates that the administration of glutamine can be safely implemented without a negative measurable effect on tumor progression and patient survival. Thus far, only a few clinical studies have investigated the effects of supplementation with glutamine on cancer treatment and outcomes. In one study, Topkan et al. focused on patients with locally advanced non-small-cell lung cancer undergoing chemoradiotherapy. They discovered that the overall survival, progression-free survival, and local/regional progression-free survival did not differ significantly between the glutamine (30 g per day) treatment group and no glutamine treatment group at a median follow-up of 24.2 months [Several studies have demonstrated that glutamine protects normal cells from the toxicity of chemoradiotherapy without adversely affecting the effectiveness of cancer therapy. Rubio et al. constructed a cancer model in rats to examine the effects of treatment with methotrexate. The total amount of methotrexate in tumors exhibited a three-fold increase in the glutamine group compared to the control group. The results suggested that glutamine enhances the sensitivity of tumor cells to chemotherapy [Glutathione is the main intracellular antioxidant that protects cells from oxidative damage [Glutamine has been used in the fields of bone marrow transplantation and intensive care, such as in patients with postoperative sepsis, multiple traumas, and severe burns [In several clinical studies demonstrating the relationship between glutamine administration and clinical outcomes, including our present results, the dose of glutamine was 30 g per day orally (10 g three times a day at 10 g per dose) [The main limitation of the present study is that it only included patients with head and neck cancer. The sensitivity to glutamine varies depending on the carcinoma and tissue type. Additional research studies are required to determine whether glutamine influences cancer treatment and outcomes and reduces the incidence rate of treatment-related adverse events in various types of cancer. In our study, 30 g per day of glutamine was administered during the course of chemoradiotherapy. Importantly, the dose of glutamine that reduces the occurrence of adverse events without affecting outcomes remains to be determined in other cancers.