Tolerability of the cytoprotective agent amifostine in elderly patients receiving chemotherapy: a comparative study.
In order to determine if age and comorbidity influence the tolerability of the cytoprotective agent amifostine, we compared side effects related to amifostine in patients > or = 70 years (group I) with patients < 70 years (group II). We evaluated 268 consecutive administrations of amifostine (119 in group I and 149 in group II, respectively), given i.v. at a dose of 740 mg/m(2) just before platinum-, taxol- or cyclophosphamide-based chemotherapy. Transient hypotension was the most common side effect occurring in association with amifostine. Decreases in systolic blood pressure > 20 mmHg were of similar frequency in both groups (27.1 versus 28.8% of amifostine infusions in group I and II, respectively). Hypotension did not result in medical sequelae in any of the patients. The amifostine infusion was interrupted 16 times in group I and 8 times in group II, respectively, mainly due to hypotension, but could be restarted after a few minutes in all patients except for three cases in group I. Patients in group II more often suffered from nausea/vomiting than in group II (20.8 versus 10.0% in group I). Other subjective symptoms (e.g. warmed, flushed sensation, sneezing, metallic taste, mouth dryness, dizziness and sleepiness) and hypocalcemia occurred with a similar frequency in both groups. Adverse effects associated with amifostine were not observed more frequently in elderly patients than in younger ones, although more elderly patients had a comorbidity than the younger ones.
Genvresse
I
I
Internal Medicine II, Department Hematology/Oncology, Humboldt University, University Hospital Charité, 10117 Berlin, Germany. isabelle.genvresse@charite.de
Lange
C
C
Schanz
J
J
Schweigert
M
M
Harder
H
H
Possinger
K
K
Späth-Schwalbe
E
E
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004999:Amifostine / Q000008:administration & dosage* / Q000633:toxicity*; D000959:Antihypertensive Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000633:toxicity; D001943:Breast Neoplasms / Q000188:drug therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004317:Doxorubicin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000188:drug therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D006973:Hypertension / Q000150:complications; D006996:Hypocalcemia / Q000139:chemically induced / Q000453:epidemiology*; D007022:Hypotension / Q000139:chemically induced; D007262:Infusions, Intravenous; D008175:Lung Neoplasms / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000453:epidemiology*; D017239:Paclitaxel / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000188:drug therapy; D010984:Platinum / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage; D011292:Premedication; D012189:Retrospective Studies; D014750:Vincristine / Q000008:administration & dosage; D000093542:Gemcitabine
D000959:Antihypertensive Agents; D003841:Deoxycytidine; D015251:Epirubicin; D010984:Platinum; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D004999:Amifostine; D017239:Paclitaxel; D005472:Fluorouracil; D011241:Prednisone; D000093542:Gemcitabine