Amifostine reduces side effects and improves complete response rate during radiotherapy: results of a meta-analysis.
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.
Sasse
André Deeke
AD
Núcleo Brasileiro de Oncologia Baseada em Evidências, Campinas, Sao Paulo, Brazil. sasse@evidencias.com.br
Clark
Luciana Gontijo de Oliveira
LG
Sasse
Emma Chen
EC
Clark
Otávio Augusto Camara
OA
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
D011837:Radiation-Protective Agents; D004999:Amifostine