title: Amifostine reduces side effects and improves complete response rate during radiotherapy: results of a meta-analysis.
abstract: OBJECTIVE
  To evaluate the efficacy of amifostine in diminishing radiotherapy side effects and whether or not it protects the tumor.
  
  
  METHODS
  We performed a systematic review and meta-analysis of 14 included randomized controlled trials, comprising 1451 patients, comparing the use of radiotherapy vs. radiotherapy plus amifostine for cancer treatment.
  
  
  RESULTS
  The use of amifostine significantly reduced the risk of developing mucositis (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.29-0.48; p < 0.00001), esophagitis (OR, 0.38; CI, 0.26-0.54; p < 0.00001), acute xerostomia (OR, 0.24; CI, 0.15-0.36; p < 0.00001), late xerostomia (OR, 0.33; CI, 0.21-0.51; p < 0.00001), dysphagia (OR, 0.26; CI, 0.07-0.92; p = 0.04), acute pneumonitis (OR, 0.15; CI, 0.07-0.31; p < 0.00001) and cystitis (OR, 0.17; CI, 0.09-0.32; p < 0.00001). There was no difference in overall response rate between the groups. However, complete response rate was superior for patients using amifostine (OR, 1.81; CI, 1.10-2.96; p = 0.02).
  
  
  CONCLUSIONS
  This systematic review shows that amifostine significantly reduces the side effects of radiation therapy. The efficacy of radiotherapy was not itself affected by the use of this drug and patients receiving amifostine were able to achieve higher rates of complete response.
authors.affiliation: Núcleo Brasileiro de Oncologia Baseada em Evidências, Campinas, Sao Paulo, Brazil. sasse@evidencias.com.br
authors.forename: André Deeke
authors.initials: AD
authors.lastname: Sasse
authors.forename: Luciana Gontijo de Oliveira
authors.initials: LG
authors.lastname: Clark
authors.forename: Emma Chen
authors.initials: EC
authors.lastname: Sasse
authors.forename: Otávio Augusto Camara
authors.initials: OA
authors.lastname: Clark
mesh_terms: D004999:Amifostine / Q000627:therapeutic use*; D003556:Cystitis / Q000517:prevention & control; D003680:Deglutition Disorders / Q000517:prevention & control; D004941:Esophagitis / Q000517:prevention & control; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000517:prevention & control*; D017564:Radiation Pneumonitis / Q000517:prevention & control; D011837:Radiation-Protective Agents / Q000627:therapeutic use*; D011855:Radiodermatitis / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D013280:Stomatitis / Q000517:prevention & control; D014987:Xerostomia / Q000517:prevention & control
chemical_list: D011837:Radiation-Protective Agents; D004999:Amifostine