Double-blind placebo-controlled multicenter phase II trial to evaluate D-methionine in preventing/reducing oral mucositis induced by radiation and chemotherapy for head and neck cancer

Head & Neck
Daniel A HamstraAlnawaz Rehemtulla

Abstract

The purpose of this study was to test if oral D-methionine (D-met) reduced mucositis during chemoradiotherapy. We conducted a placebo-controlled double-blind randomized phase II trial of D-met (100 mg/kg p.o. b.i.d.) testing the rate of severe (grades 3-4) mucositis. Sixty patients were randomized. Grade 2 + oral pain was higher with placebo (79% vs 45%; P = .0165), whereas grade 2 + body odor was greater with D-met (3% vs 41%; P = .0015). Mucositis was decreased with D-met by the physician (World Health Organization [WHO], P = .007; Radiation Therapy Oncology Group [RTOG], P = .009) and patient functional scales (RTOG, P = .0023). The primary end point of grades 3 to 4 mucositis on the composite scale demonstrated a decrease with D-met (48% vs 24%; P = .058), which was borderline in significance. A planned secondary analysis of a semiquantitative scoring system noted decreased oral ulceration (2.2 vs 1.5; P = .023) and erythema (1.6 vs 1.1; P = .048) with D-met. Although not meeting the primary end point, results of multiple assessments suggest that D-met decreased mucositis.

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Citations

Apr 3, 2019·The Journal of International Medical Research·Hui SunTao Cheng
Feb 20, 2020·International Journal of Molecular Sciences·Elena ConteAntonella Liantonio
Aug 28, 2020·Frontiers in Bioengineering and Biotechnology·Sergio Martínez-RodríguezEsperanza Ortega
Aug 17, 2019·International Journal of Molecular Sciences·Yi-Ta HsiehWan-Chun Li
Aug 1, 2020·Reviews on Recent Clinical Trials·Areti GkantaifiMaria Tolia

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