Amifostine, in a reduced dose, protects against severe diarrhea associated with weekly fluorouracil and folinic acid chemotherapy in advanced colorectal cancer: a pilot study.
Fifty-two consecutive patients with advanced colorectal cancer who developed persistent diarrhea following chemotherapy with 5-fluorouracil despite dose reduction were treated with amifostine 800, 500 or 150 mg/m(2). The administered dose of 5-fluorouracil was significantly greater during amifostine treatment. Amifostine 800 mg/m(2) was associated with complete elimination of diarrhea, but 76.3% of patients developed infusion-related hypotension. At a dose of 500 mg/m(2), diarrhea was significantly reduced and milder compared with baseline and the incidence of hypotension was 54.2%. At the lowest dose of amifostine, 17.1% of patients developed Grade 1 diarrhea, a significant reduction over baseline, and hypotension occurred in 25.2% of patients. Treatment with amifostine also improved mucositis but had no effect on the relatively mild nausea and vomiting due to 5-fluorouracil. In this study, amifostine reduced the incidence and severity of diarrhea associated with 5-fluorouracil in patients with advanced colorectal cancer, with acceptable efficacy at a reduced dose that offered better tolerability.
Tsavaris
Nicolas
N
Department of Pathophysiology, Laikon General Hospital, University of Athens, 115 27 Athens, Greece.
Kosmas
Christos
C
Vadiaka
Maria
M
Zonios
Dimitris
D
Papalambros
Efstathios
E
Papantoniou
Nikitas
N
Margaris
Heraklis
H
Zografos
George
G
Rokana
Sofia
S
Retalis
George
G
Koufos
Christos
C
D000368:Aged; D000369:Aged, 80 and over; D004999:Amifostine / Q000008:administration & dosage*; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D003967:Diarrhea / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage* / Q000009:adverse effects*; D008297:Male; D010865:Pilot Projects; D012720:Severity of Illness Index
D000964:Antimetabolites, Antineoplastic; D004999:Amifostine; D002955:Leucovorin; D005472:Fluorouracil