Utilização da glutamina na prevenção e no controle da mucosite oral radioinduzida

Abstract

The purpose of this research was to evaluate the utilization of glutamine in prevention and control of radiation-induced oral mucositis in patients with oral and oropharynx Spinocell Carcinoma. It was constituted in a clinic experiment, double-mind, randomized, placebo-controlled. The patients were distributed consecultively in two groups: Group I (n=8) received 2g of glutamine diluted in 15ml of saline solution, while Group II (n=9) used 15ml of saline solution 0,9%. The patients were oriented to swish and then spit the mouthwash out four times daily during the radiotherapy and continued one week after the end of the therapy. According to the classification proposed by the World Health Organization, used in this research to establish the grade of objective oral mucositis, 25% of the patients of the experimental Group developed grade 2 mucositis, whereas, in the control Group, mucositis (grade 1, 2, and 3) was encountered in 88,9% of the patients; the difference between the two groups was statistically significant (p=0,003). In Group I the occurrence of grade 2 mucositis reduced through the weeks of radiotherapy; in the Group II, grade 1, grade 2, and grade 3 mucositis increased through these weeks; none of the pacients who used glutamine developed grade 3 and grade 4 mucositis, however, in 66,7% of the patients who used saline solution grade 3 mucositis level 3 was encountered. With regard to subjective oral mucositis, it was not observed significant differences between the experimental Group and the control one (p=0,061), however, none of the pacients in Group I had developed grade 3 and 4 subjective oral mucositis. Based on the observed sample, we concluded that glutamine prevented the emergence of radiation-induced objective oral mucositis and reduced significantly its severity and duration; moreover, in the experimental group, we observed coherence among the results found of objective and subjective oral mucositis with regard to severity.