Amifostine for children with medulloblastoma treated with cisplatin-based chemotherapy.
In adult patients, amifostine appears to ameliorate cisplatin-related nephrotoxicity and ototoxicity. We assessed the safety and efficacy of amifostine in 11 children with newly diagnosed medulloblastoma/primitive neuroectodermal tumor treated with radiotherapy and vincristine, lomustine, and cisplatin. Amifostine was administered immediately prior to and 4 hr into the cisplatin infusion. Amifostine caused assymptomatic hypotension and hypocalcemia in 18 and 82% of patients, respectively. Despite amifostine use, 78% of patients developed significant ototoxicity. Although relatively well tolerated, amifostine does not appear to have a major impact on ameliorating the risk of developing significant nephro- and ototoxicity in children with medulloblastoma. Larger studies will help clarify these findings.
Fisher
Michael J
MJ
Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. fisherm@email.chop.edu
Lange
Beverly J
BJ
Needle
Michael N
MN
Janss
Anna J
AJ
Shu
Hui-Kuo G
HK
Adamson
Peter C
PC
Phillips
Peter C
PC
D004999:Amifostine / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage* / Q000633:toxicity; D004347:Drug Interactions; D004427:Ear Diseases / Q000139:chemically induced / Q000517:prevention & control; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007674:Kidney Diseases / Q000139:chemically induced / Q000517:prevention & control; D008297:Male; D008527:Medulloblastoma / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy; D020011:Protective Agents / Q000008:administration & dosage* / Q000633:toxicity; D016896:Treatment Outcome
D020011:Protective Agents; D004999:Amifostine; D002945:Cisplatin