Intrarectal administration of amifostine seems to have a cytoprotective efficacy in acute radiation-induced rectal mucositis. Further randomized studies are needed for definitive therapeutic decisions.
Purpose: To study the cytoprotective impact of amifostine against acute radiation mucositis. Patients and Methods: A total of 117 cancer patients with carcinomas localized in pelvic organs, lung and head and neck were entered into this study. In a retrospective way, and in order to minimize the bias related to the investigator, 138 patients as historical controls were randomly selected from a database in our hospital. Acute radiation-induced gastrointestinal mucositis, esophagitis and stomatitis were assessed using the common toxicity criteria scale. The most severe grade recorded was evaluated as the final morbidity score for this patient. Mean toxicity score (MTS) was the mean value of recorded acute radiation toxicity. Mean interruption time (MIT) was the mean value of recorded interruption time due to radiation toxicity. Results: A significantly reduced severity of symptomatology related to oral, esophageal and rectal mucosa was noted in the amifostine group (group A) (p < 0.05, chi-square test). Furthermore, a significant reduction of MTS as well as MIT was observed in group A versus the historical controls (group B) (p < 0.05, Mann-Whitney U test). Conclusion: The administration of amifostine seems to protect patients against radiation-induced mucositis, but further investigation with randomized trials is needed.
Amifostine seems to have a significant cytoprotective efficacy in acute radiation-induced rectal mucositis in terms of symptomatic and objective endpoints.
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