Effectiveness of glutamine in the management of oral mucositis in cancer patients: a meta-analysis of randomized controlled trials

Peng, Tzu‐Rong; Lin, Hung-Hong; Yang, Li-Jou; Wu, Tingqing

doi:10.1007/s00520-021-06060-9

Cited by 15 publications

(12 citation statements)

References 38 publications

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“…Therefore, the oral mucosa of patients undergoing radiotherapy, especially when repeated, should be closely observed and early intervention should be given to alleviate the pain of patients. The use of glutamine can reduce the incidence of grade III and IV oral mucositis caused by radiotherapy or chemotherapy (20).…”

Section: Incidence Of Oral Mucositis In Patients With Malignant Tumorsmentioning

confidence: 99%

Risk factors for oral mucositis in patients with malignant tumors: a prospective cohort study

Chen¹,

Yao²,

Shan³

et al. 2021

Ann Palliat Med

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Background: To investigate the incidence and risk factors of oral mucositis in patients with malignant tumors.Methods: A total of 74 patients with malignant tumors who were hospitalized in the Affiliated Hospital of Nantong University from January 2020 to December 2020 were selected and divided into two groups according to whether oral mucositis occurred (n=45) or not (n=29). Chi-square test was used to compare the general data between the two groups, and multivariate logistic regression analysis was used to investigate the risk factors of oral mucositis in patients with malignant tumors.Results: Oral mucositis occurred in 45 of 74 malignant tumor patients (60.8%), and the incidence in patients with head and neck tumors was significantly higher than in those with chest and abdomen tumors (P<0.05). A significantly higher incidence was also seen in patients with poor oral cleanliness in comparison to those with high oral cleanliness; in radiotherapy patients in comparison to non-radiotherapy patients; in patients who received Nituzumab during radiotherapy in comparison to those who did not, and in patients receiving eight cycles of chemotherapy in comparison to those not receiving chemotherapy. Multivariate logistic regression analysis showed that oral cleanliness, radiotherapy, and duration of radiotherapy were independent risk factors for oral mucositis in patients with malignant tumors (P<0.05).Conclusions: Poor oral cleanliness, radiotherapy, and longer duration of radiotherapy lead to the occurrence of oral mucositis in patients with malignant tumors, and these risk factors should be targeted for intervention to reduce the occurrence of oral mucositis.

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Section: Incidence Of Oral Mucositis In Patients With Malignant Tumorsmentioning

confidence: 99%

Risk factors for oral mucositis in patients with malignant tumors: a prospective cohort study

Chen¹,

Yao²,

Shan³

et al. 2021

Ann Palliat Med

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“…The model starts from an initiation phase, to primary damage response, signal amplification, ulceration, and ultimately a healing phase. In clinic, glutamine supplement was the most common option for treating patients with OM, yet the efficacy of glutamine on reducing incidence and severity of OM in cancer patients is still controversial [3,4] . Recombinant human keratinocyte growth factor, palifermin, was also approved for patients with blood cancers receiving high dose chemoradiotherapy before bone marrow transplantation [5] .…”

Section: Introductionmentioning

confidence: 99%

“…In clinic, glutamine supplement was the most common option for treating patients with OM, yet the efficacy of glutamine on reducing incidence and severity of OM in cancer patients is still controversial. [ 3 , 4 ] Recombinant human keratinocyte growth factor, palifermin, was also approved for patients with blood cancers receiving high dose chemoradiotherapy before bone marrow transplantation. [ 5 ] However, the effects of palifermin on patients with other cancer types who are also diagnosed with OM remain unknown, which reveals that more therapeutics should be developed to treat ulcerative mucositis.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of GMI, a fungal immunomodulatory protein, for head and neck cancer patients with chemotherapy-related oral mucositis

Kang

et al. 2022

Medicine

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Background:Cancer patients usually suffer from intensive chemotherapy-related oral mucositis (OM), yet limited effective treatment can rapidly alleviate OM severity.Methods:This prospective study examined the efficacy of Reishimmune-S containing one fungal immunomodulatory protein, GMI on OM in patients with head and neck cancer. Patients with head and neck cancer and the diagnosis of chemotherapy-related OM were enrolled randomizedly to receive standard supportive care with/without Reishimmune-S 500 mg/day orally for consecutive 14 days. Due to intolerance to standard supportive care alone in the control arm, only the experimental arm with Reishimmune-S supplementation was analyzed in our trial. OM grading was evaluated as the primary outcome on day 1, 8, and 15. Secondary outcomes were absolute neutrophil counts and quality of life assessed by the EORTC-QLQ-H&N 35 questionnaire on day 1, 8, and 15.Results:Reishimmune-S supplement significantly reduced OM grading both at day 8 and 15. Trouble with social contact and weight loss conditions were also improved by Reishimmune-S. Reishimmune-S did not significantly affect absolute neutrophil counts during the 15-day follow-up.Conclusion:Reishimmune-S supplement potentially alleviates the severity of chemotherapy-mediated OM.

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“…Similarly, amifostine was shown to be effective in preventing severe mucositis [5,6]. Oral rinses with glutamine and supersaturated Ca 2+ (PO 4 ) 2 both showed benefit in preventing and treating OM, but their effect in patients receiving stem cell transplantation appeared to be weak [7,8]. Oral cryotherapy (e.g., ice chips) applied before, during, and shortly after the infusion of high dose melphalan is an inexpensive and effective preventive measure.…”

Section: Introductionmentioning

confidence: 99%

Methylene blue for intractable pain from oral mucositis related to cancer treatment: a randomized phase 2 clinical trial

Roldan

Huh

Song

et al. 2022

BMC Med

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Background Oral mucositis (OM) in patients receiving cancer therapy is thus far not well managed with standard approaches. We aimed to assess the safety and effectiveness of methylene blue (MB) oral rinse for OM pain in patients receiving cancer therapy. Methods In this randomized, single-blind phase 2 clinical trial, patients were randomized to one of four arms: MB 0.025%+conventional therapy (CTx) (n = 15), MB 0.05%+CTx (n = 14), MB 0.1%+CTx (n = 15), or CTx alone (n = 16). Intervention groups received MB oral rinse every 6 h for 2 days with outcomes measured at days 1–2; safety was evaluated up to 30 days. The primary outcome measured change in the pain numeric rating scale (0–10) from baseline to day 2. Secondary outcome measured change in oral function burden scores from baseline to day 2, World Health Organization OM grades, morphine equivalent daily doses, and adverse events. The trial was registered with ClinicalTrials.gov ID: NCT03469284. Results Sixty patients (mean age 43, range 22–62 years) completed the study. Compared with those who received CTx alone, those who received MB had a significant reduction of pain scores at day 2 of treatment (mean ± SD); 0.025%: 5.2 ± 2.9, 0.05%: 4.5 ± 2.9, 0.1%: 5.15 ± 2.6) and reduction of oral function burden scores (0.025%: 2.5 ± 1.55, 0.05%: 2.8 ± 1.7, 0.1%: 2.9 ± 1.60). No serious adverse events were noted, but eight patients reported burning sensation of the oral cavity with the first dose, and this caused one patient to discontinue therapy. Conclusions MB oral rinse showed significant pain reduction and improved oral functioning with minimal adverse effects. Trial registration ClinicalTrials.gov ID: NCT03469284.

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Effectiveness of glutamine in the management of oral mucositis in cancer patients: a meta-analysis of randomized controlled trials

Cited by 15 publications

References 38 publications

Risk factors for oral mucositis in patients with malignant tumors: a prospective cohort study

Risk factors for oral mucositis in patients with malignant tumors: a prospective cohort study

Efficacy of GMI, a fungal immunomodulatory protein, for head and neck cancer patients with chemotherapy-related oral mucositis

Methylene blue for intractable pain from oral mucositis related to cancer treatment: a randomized phase 2 clinical trial

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