Prevention of acute radiation enteritis: efficacy and tolerance of glutamine

Purpose Our primary endpoint is to determine the effect of L-glutamine Resource (Nestle Healthcare Nutrition) in the prevention of induced enteritis after pelvic radiotherapy (RT). Methods We observed the incidence of diarrhoea during and after pelvic radiation therapy in patients receiving L-glutamine Resource (Nestle Healthcare Nutrition) supplementation. To assess results, patients were stratified according to prior treatment (prior surgery and/or concomitant chemotherapy, or no prior or concomitant treatment). Results Incidence of diarrhoea observed is similar to published series in which glutamine is not administered. Grade 1 intestinal toxicity was observed in 4 patients (15.4%), grade 2 in 10 patients (38.4%) and grade 3 in 5 patients (19.2%). Mean dose of RT at the start of enteritis was 23.55 Gy (12-40). No grade 4 toxicity occurred and in 7 patients (27%) no toxicity was reported. No differences in toxicity incidence were observed between RT dose levels. Conclusions Administration of glutamine to patients during pelvic RT does not appear to prevent the incidence of enteritis (diarrhoea). No differences were observed between patients who underwent concomitant chemotherapy (where you would expect an increase in toxicity) and those who did not.