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Effectiveness of glutamine for the treatment of radiodermatitis in cancer patients: a meta-analysis of randomized controlled trials

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Abstract   

Background

After receiving radiation therapy, 60%–95% of patients with cancer develop radiodermatitis, which causes pain, wound infection, and poor quality of life. Glutamine is a popular nutritional supplement for patients with cancer. Several studies examined the usefulness of glutamine for reducing radiodermatitis. However, there is still no consolidated evidence for clinical use.

Methods

We searched PubMed, Embase, Cochrane Library, CINAHL PLUS, and the China Knowledge Resource Integrated Database for the relevant literature published up to March 2023, without language restrictions. Two reviewers screened, filtered, and appraised these articles independently, and their data were pooled using a random-effects model.

Results

Five randomized controlled trials (RCTs) with 218 participants were analyzed. The incidence of radiodermatitis in the glutamine group (89/110) was significantly lower than in the placebo group (99/108; risk ratio [RR], 0.90; 95% CI, 0.81–1.00; p = 0.05; I2 = 7%). The incidence of moderate to severe radiodermatitis was significantly lower in the glutamine group than in the placebo group (RR, 0.49; 95% CI, 0.32–0.76; p = 0.001; I2 = 52%). Moreover, subgroup analysis demonstrated heterogeneity (I2 = 52%) for moderate to severe radiodermatitis, the risk of which might be significantly reduced by a glutamine dose of 20–30 g/day (RR, 0.60; 95% CI, 0.41–0.87; I2 = 0%).

Conclusion

The meta-analysis indicate that glutamine might lead to a lower incidence of radiodermatitis, and that a glutamine dose of 20–30 g/day might decrease the incidence of moderate to severe dermatitis. Thus, the serious impact of radiodermatitis on treatment follow-up makes the clinical use of glutamine even more important.

PROSPERO number: CRD42021254394.

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Data availability

All data generated or analyzed during this study are included in this published article and its supplementary information files.

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Acknowledgements

This manuscript was edited by Wallace Academic Editing.

Funding

This research did not receive a specific grant from any funding agency in the public, commercial, or non-profit sectors.

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Authors and Affiliations

  1. School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan

    Hsu-Chieh Chang & Tsai-Wei Huang

  2. Department of Nursing, Tri-Service General Hospital Beitou Branch, National Defense Medical Center, Taipei, Taiwan

    Hsu-Chieh Chang

  3. Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Wen-Yen Huang

  4. Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Po-Huang Chen

  5. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan

    Tsai-Wei Huang

  6. Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Tsai-Wei Huang

  7. Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Tsai-Wei Huang

  8. Department of Nursing, Faculty of Medicine, Universitas Pendidikan Ganesha, Bali, Indonesia

    Made Satya Nugraha Gautama

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Contributions

H.C.C. and T.W.H. devised and designed the study, H.C.C., WYH, and PHC extracted the data, H.C.C. and T.W.H. analyzed and interpreted the data, and H.C.C. and T.W.H. drafted the manuscript. All authors contributed to the subsequent drafts and approved the final version of the manuscript.

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Correspondence to Tsai-Wei Huang.

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Chang, HC., Huang, WY., Chen, PH. et al. Effectiveness of glutamine for the treatment of radiodermatitis in cancer patients: a meta-analysis of randomized controlled trials. Support Care Cancer 32, 201 (2024). https://doi.org/10.1007/s00520-024-08411-8

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