[Outcome of primary combined radio-chemotherapy in head and neck tumors with simultaneous salivary gland protection by amifostine].
OBJECTIVE
Demonstration and critical evaluation of the use of cytoprotective agents in radiation therapy.


METHODS
In 1996 9 patients with head and neck tumors were irradiated with a mean dose of 66 Gy and simultaneous application of amifostine. Primaries were in the oropharynx (3), tongue (2), tonsils (2) as well as nasopharynx and soft palate. Parallel carboplatin was administered 6 times with a dose of 100 mg/week and amifostine twice a week with 500 mg over 6 weeks. The evaluation was performed clinically and by sialoscintigraphy (Figure 1).


RESULTS
There were no lasting side effects, but episodes of hypotension in 7 of 9 patients and nausea. Radiogenic acute toxicity was nearly uneffected, complaints from xerostomia, however, were diminished. All patients showed increased dermal pigmentation and dermatitis. Sialoscintiraphies 6 months after therapy proved better salivary gland function with correlated better patient condition.


CONCLUSIONS
Amifostine might gain a role in the prevention of lasting radiogenic xerostomia. The required dose is not yet clear. A broader use of amifostine would be favored by lower costs of the substance.
Schultze
J
J
Klinik für Strahlentherapie (Radioonkologie) im Klinikum, Christian-Albrechts-Universität zu Kiel.
Kimmig
B
B
D004999:Amifostine / Q000494:pharmacology*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011837:Radiation-Protective Agents / Q000494:pharmacology*; D011877:Radionuclide Imaging; D011879:Radiotherapy Dosage; D012469:Salivary Glands / Q000000981:diagnostic imaging / Q000187:drug effects / Q000528:radiation effects; D013997:Time Factors; D016896:Treatment Outcome; D014987:Xerostomia / Q000209:etiology / Q000517:prevention & control
D000970:Antineoplastic Agents; D011837:Radiation-Protective Agents; D016190:Carboplatin; D004999:Amifostine
Ergebnisse der primären kombinierten Radiochemotherapie von Kopf-Hals-Tumoren mit simultaner Speicheldrüsenprotektion durch Amifostin.