Radiation mucositis

Inflammation and ulceration of oral, oesophageal or intestinal mucosa during radiotherapy and chemoradiotherapy. Reduces quality of life and impairs nutrition. Presents with pain, dysphagia and diarrhoea.

ICD-10 K12.301 drug

Also known as: Oral mucositis after radiotherapy, Radiation-induced mucositis

Drugs used for this condition

BL-glutamine (free amino acid)Add-on therapy · Conditionally essential amino acid; the main nitrogen source for nucleotide synthesis and fuel for enterocytes and immune cells. Normally supplied by dietary protein (meat, fish, eggs, dairy, legumes) and synthesised in skeletal muscle. Supplements market it as a remedy for «leaky gut», post-workout recovery, immune support in cancer patients, and a sugar-craving reducer. Neither AEMPS nor EMA registers it for supplement indications; a specialty drug exists (Endari, L-glutamine, FDA-approved) for sickle-cell disease to reduce pain-crisis frequency – this is a specialised clinical niche, not a supplement. AESAN classifies general L-glutamine supplements as complementos alimenticios.L-glutamine is used to prevent oral mucositis during chemo- and radiotherapy. MASCC/ISOO 2019 gave a positive recommendation (suggestion in favor) for oral glutamine in mucositis from head-and-neck radiotherapy; several meta-analyses showed reduced severity of severe mucositis. For the parenteral route in hematopoietic stem-cell transplantation the recommendation is negative. ASCO and ESPEN treat glutamine as optional supportive care. Glutamine is harmless; the oncologist chooses dose and form for supportive use.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit