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We conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs) that investigated glutamine efficacy in preventing and alleviating radiation‐induced oral mucositis (OM) among patients with head and neck (H&N) cancer. We screened five databases from inception till February 4, 2021 and followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. We included 11 RCTs, comprising 922 patients (458 and 464 patients were assigned to glutamine and control group, respectively). The incidence and onset of radiation‐induced OM of any grade did not substantially differ between both groups. However, glutamine substantially reduced the severity of radiation‐induced OM, as reflected by the reduced incidence of severe OM and reduced mean maximal OM grade score. Additionally, glutamine significantly decreased the rates of analgesic opioid use, nasogastric tube feeding, and therapy interruptions. Oral glutamine supplementation demonstrated various therapeutic benefits in preventing and ameliorating radiation‐induced OM among patients with H&N cancer.

Objective: To compare the analgesic efficacy of hydrogen peroxide (H2O2) mouth rinse with control for post-tonsillectomy pain management. Design: Double-blinded, prospective, randomized, controlled clinical trial. Patients and Methods:Thirty-seven patients from 5 to 14 years old undergoing electrocautery tonsillectomy were randomized to either the H2O2 mouth rinse or the water rinse (control) group. For 14 days, patients recorded pain levels twice daily using a visual analogue scale. Analgesic uses, as well as any complications, were also noted by the patients.Results: Thirty-seven patients completed the study, 21 in the treatment group and 16 in the control group. Mean postoperative days of pain were 10.3 and 8.3, respectively, and differed significantly (p = .008). Mean postoperative days of analgesic use were 9.0 and 6.7, respectively, and differed significantly (p = .005). Only one incidence of postoperative hemorrhage occurred in the study group.Conclusion: In our study, the H2O2 mouth rinse does not provide a better analgesic effect than the water rinse for posttonsillectomy pain relief. SommaireObjectif: Comparer l'efficacité analgésique du peroxyde d'hydrogène (H2O2) en gargarisme pour le contrôle de la douleur post-amygdalectomie. Devis: Etude prospective, contrôlée, randomisée, à double insu. Méthodes: Trente-sept patients âgés entre 5 et 14 ans ont été randomisés après une amygdalectomie au cautère entre le groupe contrôle (gargarisme à base d'eau) et le groupe de gargarisme au peroxyde d'hydrogène. Les patients ont mesuré leur douleur sur une échelle visuelle analogue deux fois par jour pour 14 jours. Les patients ont aussi noté leur utilisation d'analgésiques et toute complications ou problème particulier.Résultats: Trente-sept patients ont terminé l'étude, 21 dans le groupe traitement et 16 dans le groupe contrôle. Le nombre de jours avec douleur a été de 10.3 et 8.3 respectivement en moyenne, ce qui a atteint la significativité statistique (p = .008). Le nombre moyen de jours où des analgésiques ont été nécessaires était aussi différent (9.0 vs 6.7 ; p = .005). Nous n'avons noté qu'un seul cas d'hémorragie postopératoire.Conclusion: Dans cette étude, le gargarisme d'H2O2 n'offrait aucun avantage sur le gargarisme à l'eau durant la période post-amygdalectomie.

This study examines functional outcome (speech and swallowing), survival, and disease control in patients receiving an intensified treatment regimen with primary aggressive surgery, and postoperative radiotherapy or postoperative concomitant chemoradiotherapy, for previously untreated, resectable, stage III and IV squamous cell carcinoma (SCC) of the tongue base. Sixty-six consecutive patients treated from June 1997 to June 2006 were followed prospectively through the Multidisciplinary Head and Neck Surgery Reconstruction Clinic. Speech and swallowing data were gathered at four evaluation times during the first year. Speech assessment was conducted by PERCI, Nasometer, and C-AIDS and swallowing assessment by Modified barium swallow, Diet survey and G-tube. Also, the overall survival, disease-specific survival and loco regional control were measured. The average age of the patients was 56.8, 85 % male and 15 % female. All patients had primary surgical resection and 83 % received postoperative radiotherapy and 17 % chemoradiation therapy. Overall survival at 3 years was 80.3 % and 5 years 52.2 %. Disease-specific survival at 3 years was 86.7 % and 5 years was 77.5 %. Local control was 94 %. Distal metastasis and second primary were found to be 7.5 % each. Primary surgical treatment of advanced BOT cancer offers excellent functional outcome, local control and disease-specific survival.