Influence of amifostine on late radiation-toxicity in head and neck cancer--a follow-up study.
OBJECTIVE
The late toxicities due to multimodal therapy of advanced head and neck cancers were analysed. The impact of cytoprotection with amifostine is the specific objective of this report.


METHODS
A total of 851 patients (717 men, 134 women) with head and neck cancer were included in this prospective study. Of these patients, 519/851 had received amifostine before radio(chemo)therapy, while 332 control patients had not received any kind of cytoprotection before irradiation. Primary radiochemotherapy was performed in 282 patients and adjuvant radiation was administered in 569. The follow-up examination was carried out at our outpatient department 21.4 months (median, range 2.3 to 149 months) after the primary therapy.


RESULTS
Late xerostomia was seen in 765/851 patients (89.9%). Altered taste was reported by 284/851 (33.5%). These symptoms were reduced significantly by amifostine. No influence was seen on interstitial lymph edema (48.4%), or stenosis of the cervical esophagus (20.4%). Secondary symptoms such as dysphagia (78.8%) also had a trend for reduction.


CONCLUSIONS
The administration of amifostine offers an opportunity to reduce selected long-term toxicities for survivors of head and neck cancer.
Büntzel
Jens
J
Department of Otolaryngology, Head and Neck Surgery, Südharzkrankenhaus Nordhausen, Nordhausen, Germany. jens.buentzel@shk-ndh.de
Glatzel
Michael
M
Mücke
Ralph
R
Micke
Oliver
O
Bruns
Frank
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004999:Amifostine / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D003680:Deglutition Disorders / Q000139:chemically induced / Q000188:drug therapy; D004940:Esophageal Stenosis / Q000139:chemically induced / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008209:Lymphedema / Q000139:chemically induced / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011837:Radiation-Protective Agents / Q000627:therapeutic use*; D011878:Radiotherapy / Q000009:adverse effects*; D013651:Taste Disorders / Q000139:chemically induced / Q000188:drug therapy; D013997:Time Factors; D014987:Xerostomia / Q000139:chemically induced / Q000188:drug therapy
D000970:Antineoplastic Agents; D011837:Radiation-Protective Agents; D004999:Amifostine