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Subject Area

Neurosurgery

Article Type

Original Study

Abstract

Objective The aim was to determine the effect of administration of parenteral l-alanyl-l-glutamine-containing formula on occurrence of treatment-related malnutrition and acute radiotherapy (RT)-related toxicities in patients with head and neck cancer. Background Studies have shown that glutamine-containing nutritional therapy can improve the nutritional status of adult patients with cancer. Patients and methods A total of 40 patients with head and neck carcinoma were randomized to receive either parenteral l-alanyl-l-glutamine-containing formula (0.4 mg/kg) during the first 2 weeks of RT (with or without chemotherapy) or placebo. Nutritional assessment was done for all patients at diagnosis and on weekly basis till end of treatment using subjective global assessment tool and anthropometric measures. Treatment-related toxicity was reported and graded. Quality of life (QoL) was assessed using Functional Assessment of Cancer Therapy for patients with head and neck cancer. Results There was a significant difference between the studied groups regarding subjective global assessment tool score from third week till 7th week (P = 0.019, 0.005, <0.001, <0.001, and 0.021, respectively). Low BMI was more frequent in group 2 patients. Conversely, severe weight loss was significantly different between both groups starting from third week (P = 0.020, 0.010, 0.004, 0.031, and 0.044). There was higher frequency and severity of acute RT toxicities in group 2 patients. There was a significant difference between the two groups regarding QoL as well (P = 0.005). Conclusion l-alanyl-l-glutamine nutritional supplement resulted not only in better nutritional status but also in improved treatment tolerance and QoL.

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