[Experiences with sodium selenite in treatment of acute and late adverse effects of radiochemotherapy of head-neck carcinomas. Cytoprotection Working Group in AK Supportive Measures in Oncology Within the scope of MASCC and DKG].
BACKGROUND
The principle of cytoprotection became a new supportive strategy in oncology during the last decade. Two principal ways of cytoprotection are well known in practice: the addition of external free thiols (for example amifostine) or the activation of internal detoxification-pathways (for example the activation of glutathione peroxidase) by administration of additional selenium.
We report about our experiences in both fields: At first we could show the significant possibilities of cytoprotection to reduce the acute hematological and non hematological toxicities of a simultaneous radiochemotherapy (2 cycles Carboplatin, 2 Gy single dose, 60 Gy total dose) of head and neck cancer patients. After 1 year the survival of amifostine-protected patients was better compared to the control, the rate of severe late complications (xerostomia Grade 3/4) was decreased from 57% to 14%. At second we report about the usage of selenium in the treatment of paravasats (10 patients) and interstitial lymph edema (20 patients). In the acute intervention group 9/10 patients resolved from the paravasats without any necrosis. In the late intervention group 12/20 patients showed reduced edema. Nine of 15 patients with a supraglottic edema and subsequent dyspnoea resolved under treatment without any tracheostomy.


CONCLUSIONS
On the base of these data we have planned a phase-I/II study to investigate the chances of both cytoprotectants alone and in combination in order to get the most favorable supportive regimen for our basic type of radiochemotherapy.
Büntzel
J
J
Klinik für HNO-Krankheiten, Kopf-Hals-Chirurgie, Zentralklinikum Südthüringen, Suhl/Thüringen. dr.buentzel@t-online.de
D000328:Adult; D000368:Aged; D004999:Amifostine / Q000008:administration & dosage* / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011837:Radiation-Protective Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018714:Radiotherapy, Adjuvant
D011837:Radiation-Protective Agents; D004999:Amifostine