Radiochemotherapy with amifostine cytoprotection for head and neck cancer

A randomized study was conducted to evaluate the protective activity of amifostine (A) against the dose-limiting toxicities of radiochemotherapy (RCT). Patients with head and neck cancer received radiotherapy (2 Gy/day 5 days a week up to 60 Gy) with carboplatin 70 mg/m2 on days 1-5 and 21-25 inclus...

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Bibliographic Details
Published in:Supportive care in cancer 1998-03, Vol.6 (2), p.155-160
Main Authors: BÜNTZEL, J, SCHUTH, J, KÜTTNER, K, GLATZEL, M
Format: Article
Language:English
Subjects:
Adult
Aged
Amifostine - therapeutic use
Antineoplastic Agents - adverse effects
Biological and medical sciences
Carboplatin - adverse effects
Combined Modality Therapy
Drug toxicity and drugs side effects treatment
Female
Head & neck cancer
Head and Neck Neoplasms - drug therapy
Head and Neck Neoplasms - radiotherapy
Humans
Male
Medical sciences
Middle Aged
Otorhinolaryngology (head neck, general aspects and miscellaneous)
Otorhinolaryngology. Stomatology
Pharmacology. Drug treatments
Radiation-Protective Agents - therapeutic use
Toxicity: blood
Treatment Outcome
Tumors
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Summary:A randomized study was conducted to evaluate the protective activity of amifostine (A) against the dose-limiting toxicities of radiochemotherapy (RCT). Patients with head and neck cancer received radiotherapy (2 Gy/day 5 days a week up to 60 Gy) with carboplatin 70 mg/m2 on days 1-5 and 21-25 inclusive. Patients either received RCT alone (n = 14) or RCT + A at a dose of 500 mg prior to treatment with carboplatin (n = 25). There was a significant reduction in the incidence of grade 3/4 mucositis (P < 0.0001), acute grade 2 xerostomia (P < 0.0001) and grade 3/4 thrombocytopenia (P = 0.012) in these patients who received A. The incidence of grade 2 late xerostomia at 12 months is 16.7% and the incidence of loss of taste is 0% in patients treated with A, as opposed to 54.5% and 63.6% in patients who received RCT alone. There were 18 (72%) complete responses (CR) and 6 (24%) partial responses (PR) in patients who received A, compared with 6 (43%) CR and 6 PR (43%) in patients treated with RCT alone. The disease-free survival at 12 months is 85.7% in the RCT + A arm and 78.6% in the RCT alone arm. The use of amifostine reduces the incidence and severity of acute and late toxicities associated with RCT whilst preserving antitumour activity.
ISSN:0941-4355
1433-7339
DOI:10.1007/s005200050150