Individualization of the subcutaneous amifostine dose during hypofractionated / accelerated radiotherapy.
BACKGROUND
Individualization of the daily dose of amifostine may prove of value in achieving maximum cytoprotection during radiotherapy.


METHODS
Using an algorithm based on: i) the gradual increase of the amifostine dose, ii) an amifostine tolerance-recording scale and iii) the intermittent administration of dexamethasone, the individualization of the subcutaneous amifostine dose was prospectively attempted in a large cohort of 132 cancer patients, treated with 12-15 consecutive fractions of 3.4-3.5 Gy (hypofractionated accelerated radiotherapy with cytoprotection, HypoARC).


RESULTS
Using the above algorithm, a daily dose of 1000 mg of amifostine was successfully delivered in 62% of patients. An additional 20% of patients tolerated well a mean daily dose of 750-975 mg. Nausea and fatigue were minimal, while fever/rash enforced amifostine interruption in 7% of cases.


CONCLUSIONS
Individualization of the amifostine dose allowed an up to two-fold increased daily-dose administration of amifostine and can be tested as a support to aggressive radio-chemotherapy schemes aiming at improving the cure rates of cancer patients, while avoiding excess toxicity.
Koukourakis
Michael I
MI
Department of Radiotherapy / Oncology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece. targ@her.forthnet.gr
Abatzoglou
Ioannis
I
Sivridis
Leonidas
L
Tsarkatsi
Maria
M
Delidou
Helen
H
D000465:Algorithms; D004999:Amifostine / Q000008:administration & dosage* / Q000009:adverse effects; D003907:Dexamethasone / Q000627:therapeutic use; D019583:Dose Fractionation, Radiation; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D007206:Individuality; D007279:Injections, Subcutaneous; D009369:Neoplasms / Q000532:radiotherapy*; D011837:Radiation-Protective Agents / Q000008:administration & dosage* / Q000009:adverse effects
D011837:Radiation-Protective Agents; D003907:Dexamethasone; D004999:Amifostine