The potential influence of cell protectors for dose escalation in cancer therapy: an analysis of amifostine.
The attempt to increase the therapeutic ratio in an effort to improve survival or quality of life is the goal of modern cancer therapy. It is commonly accepted that local and systemic tumor control would increase if the dose intensity of antineoplastic drugs, radiation therapy, or the combination were increased. Radiation dose escalation using intensity-modulated radiation therapy (IMRT), accelerated or hypofractionated radiation schemes, and multidrug chemotherapy regimens are being used to try to increase tumor kill while inflicting minimal injury to normal tissue. Modern chemoradiation techniques have led to improved local regional control and increased cure rates, but the potentially severe and debilitating adverse effects of the therapies prevent them from reaching the ultimate goal of curing the disease while leaving the patient with a good quality of life. Cell protectants such as amifostine function by reducing the effects of therapy on normal cells while maintaining tumor sensitivity to the therapy. In various studies, amifostine has been analyzed and appears to be a potentially powerful adjuvant to current cancer therapy. Administering amifostine may allow dose escalation with less or equal risk to surrounding normal tissues. This could improve therapeutic efficacy, survival, and quality of life for cancer patients.
McCumber
Linda M
LM
Department of Radiation Oncology, University of North Carolina Hospital, Chapel Hill, NC 27514, USA.
D004999:Amifostine / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D019583:Dose Fractionation, Radiation; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009369:Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D011837:Radiation-Protective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
D011837:Radiation-Protective Agents; D004999:Amifostine