908 Effect of amifostine to prevent radiotherapy-induced acute and late toxicity in head and neck cancer patients who had normal or mild impaired salivary gland function

Systematic review of amifostine for the management of oral mucositis in cancer patients

“…In patients undergoing radiotherapy for head and neck cancer, five articles were reviewed [6,10,13,16,21]. In all five studies, amifostine was administered for prevention.…”

“…In all five studies, amifostine was administered for prevention. Three studies reported that amifostine reduced the severity and/or the duration of oral mucositis [13,16,21]. One of these three studies was a retrospective record review.…”

“…[21]. Placebo was not used in the control group, and the double-blinded method was not followed in the other two studies [13,16]. Furthermore, in one study, side effects of amifostine (150 mg/m 2 twice daily) led to definitive interruption of amifostine use in five out of 13 patients, making the evaluation of the effect of amifostine difficult [16].…”

“…This might possibly prevent the up-regulation of inflammatory pathways related to cancer therapy toxicity and, thus, may allow compliance with the planned treatment regimens while preserving the patient's quality of life. Amifostine, administered intravenously, has been shown to reduce the incidence of acute and late xerostomia in head and neck cancer patients who receive radiotherapy, with or without chemotherapy [4][5][6][7][8][9][10][11][12][13]. The American Society of Clinical Oncology has recommended that the cytoprotective effect of amifostine "may be considered" for the prevention of cisplatin-associated nephrotoxicity, for the reduction of grade 3-4 neutropenia and to decrease acute and late xerostomia with fractionated radiotherapy for head and neck cancer [14,15].…”

“…With regard to oral mucositis, the literature is conflicting with some studies suggesting amifostine to be beneficial in prevention of oral mucositis [4,5,7,11,13,[16][17][18][19][20][21][22][23][24] and some studies suggesting that amifostine does not reduce mucositis prevalence or severity [6,8,10,[25][26][27][28][29][30][31]. Stokman et al performed a meta-analysis of seven studies and reported a positive preventive effect of amifostine on severe oral mucositis [32].…”