Prophylactic use of amifostine to prevent radiochemotherapy-induced mucositis and xerostomia in head-and-neck cancer

Antonadou, D.; Pepelassi, Marizenia; Synodinou, M.; Puglisi, Maria Ausiliatrice; Throuvalas, N.

doi:10.1016/s0360-3016(01)02683-9

Cited by 205 publications

(116 citation statements)

References 32 publications

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“…42 In contrast, Antonadou et al did not observe a protective effect of amifostine against hematologic side effects. 38. Amifostin had no benefit regarding anemia, thrombocytopenia, or leukopenia in the current study and did not improve the results of hematologic side effects in the patients treated with concomitant CT.…”

Section: Discussioncontrasting

confidence: 61%

“…39,40 In a series of 50 cases, Antonadou et al compared patients that underwent RT+CT with or without amifostine and side effects were recorded at certain intervals. 38 They reported that treatment was interrupted due to grade 4 mucositis in six patients (28%) in the amifostine group and in 12 patients (52%) in the control group. During the third week, grade 2 mucositis developed in 9.1% of the patients in the amifostine group versus 100% of the patients in the control group.…”

Section: Discussionmentioning

confidence: 98%

“…14 The administration of amifostine prior to RT has been shown to mostly reduce the incidence of grade ≥2 acute and late side effects. 35,38 A recent update of the study by Brizel et al confrmed that the incidence of late grade ≥2 xerostomia decreased in the amifostine group. 36 In a study by Buntzel et al, the difference in grade 2 xerostomia was significant between ART and RT arms (p=0.0001).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Effect of Amifostine on Acute and Late Radiation Side Effects in Head and Neck Cancer Patients

Demiroz¹,

Özkan²,

Cebelli³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : We aimed to investigate the effect of amifostine on acute and late side effects, and its tolerability in head and neck cancer patients treated with radiotherapy (RT). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The study included 87 patients with primary head and neck cancers and cervical lymph node metastases from unknown primary cancers treated with RT alone or combined with chemotherapy (CT). Forty-one patients (47%) received amifostine combined with RT (ART group) and 46 patients (52%) received RT without amifostine (RT group). The patients were evaluated every week during the treatment and at month 1 and 2 after the completion of RT for acute side effects and month 3, 6, 9, 12, and 24 after the treatment for late side effects according to SOMA/LENT scale. Amifostine was administered prior to RT, along with anti-emetic prophylaxis. The two groups were compared with the Student's t and MannWhitney U and Chi-square tests. R Re es su ul lt ts s: : The ART group had significantly less toxicity (grade 1 mucositis, grade 2 fibrosis) than patients in the RT group (p=0.001, p=0.03, respectively). At week 3 of RT grade 2 mucositis developed in two patients (5%) in the ART group and 10 patients (22%) in the RT group (p=0.02). The protective effect of amifostine on skin reactions developed at week 4 of RT (p=0.05). Grade 3 xerostomia at 9, 12, and 15 months of follow-up (p=0.02, p=0.02, and p=0.02, respectively), grade 2 xerostomia at 18 and 24 months (p=0.02 and p=0.01, respectively) and fibrosis at 15, 18 and 24 months (p=0.05, p=0.02 and p=0.02, respectively) decreased markedly in the ART group compared with the RT group. Emesis was the most common adverse effect of amifostine. C Co on nc cl lu us si io on n: : Daily administration of amifostine during RT was effective in avoiding late grade 2-3 xerostomia, as well as grade 2 fibrosis. K Ke ey y W Wo or rd ds s: : Radiotherapy; head and neck cancer; amifostine; xerostomia Ö ÖZ ZE ET T A Am ma aç ç: : Amifostinin radyoterapi (RT) ile tedavi edilmiş baş ve boyun kanseri hastalarında akut ve geç yan etkiler üzerindeki etkisini ve tolerabilitesini araştırmayı amaçladık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmaya, tek başına RT veya RT ve eş zamanlı kemoterapi (KT) ile tedavi edilmiş primer baş ve boyun kanseri olan ve primeri bilinmeyen bir kanserden servikal lenf düğümlerine metastaz yapmış 87 hasta dâhil edildi. Kırk bir hastaya (47%) RT ile birlikte amifostin (ART grup) ve 46 hastaya (52%) amifostin olmaksızın RT (RT grubu) verildi. Olgular, tedavi sırasında akut yan etkiler açısından her hafta ve RT bittikten sonra 1. ve 2. ayda, geç yan etkiler açısından ise tedavi bittikten sonra 3., 6., 9., 12., ve 24. aylarda SOMA/LENT skalasına göre değerlendirildiler. Amifostin RT'den önce antiemetik profilaksi ile beraber uygulandı. İki grubun, komplikasyonlar üzerindeki etki açısından karşılaştırılmasında Student-t ve Mann Whitney-u testleri kullanıldı. B Bu ul lg gu ul la ar r: : AR...

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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The Effect of Amifostine on Acute and Late Radiation Side Effects in Head and Neck Cancer Patients

Demiroz¹,

Özkan²,

Cebelli³

et al. 2012

Turkiye Klinikleri J Med Sci

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“…216 Radioprotectors such as amifostine may also contribute to taste maintenance. [231][232][233][234] Zinc supplementation has shown variable outcomes in taste following cancer therapy. A small trial comparing zinc sulfate (45 mg given 3 times a day) with placebo taken during RT reported an improvement in taste in the study group.…”

Section: Managementmentioning

confidence: 99%

Oral complications of cancer and cancer therapy

Epstein

Thariat

Bensadoun

et al. 2012

CA A Cancer J Clinicians

412

356

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Answer questions and earn CME/CNEOral complications resulting from cancer and cancer therapies cause acute and late toxicities that may be underreported, underrecognized, and undertreated. Recent advances in cancer treatment have led to changes in the incidence, nature, and severity of oral complications. As the number of survivors increases, it is becoming increasingly recognized that the aggressive management of oral toxicities is needed to ensure optimal long‐term oral health and general well‐being. Advances in care have had an impact on previously recognized oral complications and are leading to newly recognized adverse effects. Here, the authors briefly review advances in cancer therapy, including recent advances in surgery, oral care, radiation therapy, hematopoietic cell transplantation, and medical oncology; describe how these advances affect oral health; and discuss the frequent and/or severe oral health complications associated with cancer and cancer treatment and their effect upon long‐term health. Although some of the acute oral toxicities of cancer therapies may be reduced, they remain essentially unavoidable. The significant impact of long‐term complications requires increased awareness and recognition to promote prevention and appropriate intervention. It is therefore important for the primary oncologist to be aware of these complications so that appropriate measures can be implemented in a timely manner. Prevention and management is best provided via multidisciplinary health care teams, which must be integrated and communicate effectively in order to provide the best patient care in a coordinated manner at the appropriate time. CA Cancer J Clin 2012. © 2012 American Cancer Society.

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“…Essa xerostomia pode ser irreversí-vel, com tendência de recuperação de até 50% da quantia inicial de saliva, caso o volume da parótida irradiado e a dose final de irradiação fique em valores os mais baixos possíveis (8)(9)(10)(11)(12) . Várias técnicas são descritas na literatura para prevenção da xerostomia e da mucosite oral, como o uso de amifostina, pilocarpina, Biotene ® , bochechos com bicarbonato de sódio, uso de antibióticos e anestésicos tópicos, entre outros, todas com suas limitações (13)(14)(15)(16)(17)(18)(19) . Lasers de baixa potência (LBP) são lasers que possuem baixa energia, sem potencial fototérmico, sendo utilizados para biomodulação.…”

Section: Introductionunclassified

Prevenção da xerostomia e da mucosite oral induzidas por radioterapia com uso do laser de baixa potência

Lopes¹,

Mas

Zângaro

2006

Radiol Bras

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OBJETIVO: Verificar se o uso do laser de InGaAlP com comprimento de onda de 685 nm pode reduzir a incidência de xerostomia, gravidade da mucosite oral e da dor associada à mucosite em pacientes portadores de câncer de cabeça e pescoço submetidos a radioterapia. MATERIAIS E MÉTODOS: Sessenta pacientes portadores de carcinoma de cabeça e pescoço foram submetidos a radioterapia com dose diária de 1,8 a 2,0 Gy e dose final de 45 a 72 Gy. O volume salivar foi medido nos dias um, 15, ao final do tratamento e após 15 e 30 dias, e a mucosite oral em avaliações semanais. Vinte e nove pacientes se submeteram a radioterapia sem laser e 31 foram submetidos a radioterapia e laser com dose diária de 2 joules/cm² em pontos pré-determinados da mucosa oral e glândulas parótida e submandibular. RESULTADOS: No grupo submetido a radioterapia e laser, a incidência de mucosite (F < 0,001) e dor (F < 0,016) foram significativamente menores e o volume salivar se manteve maior (F < 0,001) durante e após o tratamento. CON-CLUSÃO: Os pacientes submetidos à associação de radioterapia e laser tiveram menor incidência de xerostomia, mucosite oral e dor quando comparados ao grupo de radioterapia sem laser, com resultados com significância estatística. Unitermos: Laser de baixa potência; Xerostomia; Mucosite; Radioterapia; Quimioterapia.Low level laser therapy in the prevention of radiotherapy-induced xerostomia and oral mucositis. OBJECTIVE: To verify if the use of InGaAIP laser with 685 nm wave length can reduce the xerostomy incidence, the oral mucositis severity and the pain related to mucositis in patients with head and neck cancer submitted to radiotherapy. MATERIALS AND METHODS: Sixty patients presenting head and neck carcinoma were submitted to radiotherapy with daily doses of 1.8 to 2.0 Gy and a final dose of 45 to 72 Gy. The salivary volume was evaluated in the first and fifteenth days, at the end of the treatment and after 15 and 30 days. The oral mucositis was evaluated on a weekly basis. Twenty-nine patients were submitted to radiotherapy without laser and 31 were submitted to radiotherapy and laser with daily doses of 2 joules/ cm² in predetermined areas of the oral mucosa and the parotid and submandibular glands. RESULTS: In the group submitted to radiotherapy and laser the incidence of mucositis (F < 0.001) and pain (F < 0.016) was significantly lower and the salivary volume (F < 0.001) was kept higher during and after the treatment. CONCLUSION: The group of patients submitted to radiotherapy and laser had lower incidence of xerostomy, oral mucositis and pain when compared to the group treated with radioteraphy without laser, producing statistically significant results. Keywords: Low level laser; Xerostomy; Mucositis; Radiotherapy; Chemotherapy.Resumo Abstract * Trabalho realizado no Instituto de Radioterapia do Vale do Paraíba, São José dos Campos, SP.

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Prophylactic use of amifostine to prevent radiochemotherapy-induced mucositis and xerostomia in head-and-neck cancer

Cited by 205 publications

References 32 publications

The Effect of Amifostine on Acute and Late Radiation Side Effects in Head and Neck Cancer Patients

The Effect of Amifostine on Acute and Late Radiation Side Effects in Head and Neck Cancer Patients

Oral complications of cancer and cancer therapy

Prevenção da xerostomia e da mucosite oral induzidas por radioterapia com uso do laser de baixa potência

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