title: Pharmacologic normal tissue protection in clinical radiation oncology: focus on amifostine.
abstract: BACKGROUND
  Radiation toxicity is an important problem that limits treatment intensity and adversely affects patients' quality of life. Amifostine is a cytoprotector that can reduce toxicity and potentially improve the therapeutic ratio of radiotherapy.
  
  
  OBJECTIVE
  To discuss the role of amifostine in modern radiotherapy and compare and contrast with alternative approaches to reducing radiation toxicity.
  
  
  METHODS
  We conducted a literature search through Medline to identify randomized clinical trials pertaining to keyword 'amifostine'. We also consulted reviews, book chapters and selected articles regarding amifostine and normal tissue protection.
  
  
  CONCLUSIONS
  Amifostine is an effective normal tissue protector with level I evidence supporting its use in head and neck and gynecologic cancers but studies in other disease sites, although promising, are inconclusive. Further study is needed to demonstrate conclusively the benefits of wider amifostine use.
authors.affiliation: University of California San Diego, Department of Radiation Oncology, La Jolla, California, USA.
authors.forename: Loren K
authors.initials: LK
authors.lastname: Mell
authors.forename: Benjamin
authors.initials: B
authors.lastname: Movsas
mesh_terms: D004999:Amifostine / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D005833:Genital Neoplasms, Female / Q000532:radiotherapy; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy; D011832:Radiation Injuries / Q000517:prevention & control*; D011837:Radiation-Protective Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D011837:Radiation-Protective Agents; D004999:Amifostine