Department of Otolaryngology, E-Da Hospital, Kaohsiung 82445, Taiwan.
College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan.
Nutrients. 2022 Feb 26;14(5):997. doi: 10.3390/nu14050997.
Background: Oral mucositis (OM) is a common toxic side effect in nasopharyngeal carcinoma (NPC) patients receiving concurrent chemoradiotherapy (CCRT) that has a negative impact on treatment outcomes and patients’ survival. Our study aimed to evaluate the impact of parenteral glutamine supplement (dipeptiven) on oncologic outcomes in patients with NPC treated with CCRT. Methods: Patients who were diagnosed with pathologically proved NPC and treated with CCRT were enrolled into our study. Patients were classified as dipeptiven (+) and dipeptiven (−). Oncologic outcomes were measured, and multivariate regression analysis was performed. Grade 3−4 treatment related toxicities were also documented. Results: A total of 144 patients with NPC were recruited in this study to evaluate oncologic outcomes, with 41 dipeptiven (+) and 103 dipeptiven (−). CCRT interruption rate and severe adverse effect (SAE) rate were significant lower in the dipeptiven (+) group than in the dipeptiven (−) group. The median overall survival (OS) was not mature yet in the dipeptiven (+) group and 30 months in the dipeptiven (−) group (p < 0.01). Multivariate analysis demonstrated that dipeptiven supplementation and CCRT interruption were independent predictors associated with better survival. The OS was longest in patients with a dipeptiven supplement and patients who had CCRT interruption had significantly worst OS. As for safety profiles, grade 3 to 4 adverse effects were fewer in dipeptiven (+) than in dipeptiven (−). Conclusion: Dipeptiven supplementation is crucial in NPC patients treated with CCRT, which can ameliorate treatment-related toxicity and augment treatment efficacy. Further prospective clinical trials are warranted to validate our results.
口腔黏膜炎（OM）是接受同期放化疗（CCRT）的鼻咽癌（NPC）患者常见的毒副作用，对治疗结果和患者生存有负面影响。我们的研究旨在评估 NPC 患者接受 CCRT 治疗时，肠外补充谷氨酰胺（Dipeptiven）对肿瘤学结局的影响。
入组经病理证实为 NPC 且接受 CCRT 治疗的患者。患者分为 Dipeptiven（+）和 Dipeptiven（-）。测量肿瘤学结局并进行多变量回归分析。还记录了 3-4 级与治疗相关的毒性。
本研究共招募了 144 例 NPC 患者来评估肿瘤学结局，其中 41 例 Dipeptiven（+）和 103 例 Dipeptiven（-）。Dipeptiven（+）组的 CCRT 中断率和严重不良事件（SAE）率明显低于 Dipeptiven（-）组。Dipeptiven（+）组的中位总生存期（OS）尚未成熟，为 30 个月，而 Dipeptiven（-）组为 30 个月（p<0.01）。多变量分析表明，Dipeptiven 补充和 CCRT 中断是与更好的生存相关的独立预测因素。Dipeptiven 补充的患者 OS 最长，而 CCRT 中断的患者 OS 最差。在安全性方面，Dipeptiven（+）组的 3-4 级不良事件少于 Dipeptiven（-）组。
Dipeptiven 补充对接受 CCRT 治疗的 NPC 患者至关重要，它可以改善治疗相关的毒性并增强治疗效果。需要进一步的前瞻性临床试验来验证我们的结果。
