Evidence on the use of arginine in response to inflammatory markers in patients with head and neck cancer: a Review

Introduction: Patients with head and neck cancer often develop significant weight loss during perioperative period. In the last two decades, the inflammatory state observed in cancer patients are gaining substantial importance in the scientific literature since it has been related as one of the main factors associated to cachexia. Given this scenario, pharmaconutrients have shown the ability to modulate immune and inflammatory response, reducing postoperative complications and mortality. Among nutrients with those specific actions it can be highlighted arginine. Objectives: Literature review on arginine use related to inflammatory markers response, to show its benefits - if any- and appropriate dosage and duration of use in patients with head and neck cancer. Methods: There were found 14 studies on PubMed database where 5 randomized controlled trials met inclusion criteria’s and constituted the sample. Results: arginine-enriched enteral nutrition showed no benefit when compared to standard diet, if compared inflammatory markers´ such as C-reactive protein, interleukin-6 and tumor necrosis factor - alpha values. Conclusion: further studies are needed in order to determine an ideal form of arginine supplement in patients with head and neck cancer (oral, enteral or parenteral), an appropriate occasion for immunomodulatory nutrition (In the pre-operative, post-operative or perioperative) and dosage/duration more suitable for this particular population.