Effect of HMB/Arg/Gln on the Prevention of Radiation Dermatitis in Head and Neck Cancer Patients Treated with Concurrent Chemoradiotherapy

Objective: This prospective randomized Phase II study was designed to evaluate the preventive effect of an oral nutrition supplement composed of beta-hydroxy-beta-methylbutyrate, arginine and glutamine (beta-hydroxy-beta-methylbutyrate/arginine/glutamine) on radiation dermatitis in head and neck cancer patients. Methods: Forty patients with histologically proven head and neck cancer, treated with concurrent chemoradiotherapy involving cisplatin were recruited. They were randomly assigned to the beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplement treatment group (Group A) or the control group that received no supplement (Group B). The primary endpoint of this study was the percentage of patients developing Grade 3 dermatitis. The secondary endpoints were the percentage of patients developing Grade 2 dermatitis, and the duration of each grade of dermatitis relative to the observation period. Results: The incidence of Grade 3 dermatitis did not differ between the two groups. However, as secondary endpoints of this study, the incidence of Grade 2 dermatitis was lower in Group A than B (62.6 vs. 94.4%; P , 0.05), and the duration of Grade 1 dermatitis was shorter in Group A than B (44.8 vs. 56.7%; P , 0.01), as was the duration of Grade 2d ermatitis (16.5 vs. 26.5%; P , 0.05). Conclusions: Our study indicated that beta-hydroxy-beta-methylbutyrate/arginine/glutamine supplementation was potentially effective in the prevention of radiation dermatitis in head and neck cancer patients.