Impact on cytoprotective efficacy of intermediate interval between amifostine administration and radiotherapy: a retrospective analysis.
OBJECTIVE
To evaluate the cytoprotective impact of the interval between amifostine administration and radiotherapy (RT).


METHODS
In a nonrandomized study, we reviewed the records of 177 patients with tumors localized in the pelvis (prostate, bladder, or gynecologic cancer), upper abdomen (pancreas, stomach, kidney), thorax (lung and breast cancer), head and neck (nasopharynx), soft tissue (sarcomas), and central nervous system. The patient records were stratified according to whether the patients had undergone RT either 25-40 min (Group 1, 96 subjects) or 10-15 min (Group 2, 81 subjects) after i.v. amifostine administration. The mean toxicity score was the mean value of recorded acute radiation toxicity. The mean interruption time was the mean value of the recorded interruption time due to radiation toxicity.


RESULTS
A significantly reduced severity of symptoms related to oral (p = 0.023), esophageal (p = 0.05) and rectal (p = 0.015) mucosa was noted in Group 2. A statistically significant reduction in the mean toxicity score (p <0.001) and mean interruption time (p = 0.001) was observed in Group 2 vs. Group 1. In terms of the incidence of radiation-induced dermatitis and alopecia, multivariate logistic analysis revealed only the total dose (p = 0.018) and the amifostine-RT interval (p = 0.002) as independent factors.


CONCLUSIONS
A significantly better cytoprotective effect of amifostine against radiation-induced mucositis, dermatitis, and alopecia was noted if RT was administered no later than 15 min after i.v. amifostine infusion. The results presented here need additional investigation with randomized prospective trials.
Kouloulias
Vassilios E
VE
Department of Radiotherapy, Areteion University Hospital of Athens, 115 Kallergi Street, GR-18544 Pireus, Greece. vkouloul@cc.ece.ntua.gr
Kouvaris
John R
JR
Kokakis
John D
JD
Kostakopoulos
Athanasios
A
Mallas
Elias
E
Metafa
Anna
A
Vlahos
Lambros J
LJ
D004999:Amifostine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000528:radiation effects; D009369:Neoplasms / Q000532:radiotherapy*; D011837:Radiation-Protective Agents / Q000008:administration & dosage / Q000009:adverse effects*; D011855:Radiodermatitis / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D013223:Statistics as Topic; D016896:Treatment Outcome
D011837:Radiation-Protective Agents; D004999:Amifostine