Does amifostine have radioprotective effects on salivary glands in high-dose radioactive iodine-treated differentiated thyroid cancer.
OBJECTIVE
To assess the effects of amifostine on salivary glands in radioactive iodine-treated differentiated thyroid cancer.


METHODS
We searched the MEDLINE, EMBASE and the Cochrane Library for randomized controlled clinical trials which compared the effects of amifostine with those of placebo or acid-stimulating agents.


RESULTS
Two randomized controlled clinical trials with a total of 130 patients were included. Both studies had a low risk of bias. There were no statistically significant differences between the effects of amifostine and acid-stimulating agents on the incidence of xerostomia (RR 0.24, 95% CI 0.01 to 9.52), the decrease of scintigraphically measured uptake of (99m)Tc by the parotid (RR 0.30, 95% CI -2.28 to 2.88) or submandibular glands (RR 1.90, 95% CI -1.46 to 5.26) at 12 months, or the reduction in blood pressure (RR 5.00, 95% CI 0.25 to 99.16). Neither of the included trials investigated death from any cause, morbidity, health-related quality of life or costs.


CONCLUSIONS
The results of two randomized controlled clinical trials suggest that amifostine has no significant radioprotective effects on salivary glands in radioactive iodine treatment of differentiated thyroid cancer. The use of acid-stimulating agents to increase salivation should remain the first choice during radioactive iodine treatment of differentiated thyroid cancer. Patients should also be well informed of the importance of hydration and acid stimulation.
Department of Nuclear Medicine, Affiliated Hospital, Medical College, Qingdao University, Qingdao, Shandong Province, China. mc_7419@hotmail.com
Chao
C
Ma
Jiawei
J
Xie
Zhongxin
Z
Jiang
Guoming
G
Wang
Shuyao
S
Zuo
D004999:Amifostine / Q000009:adverse effects / Q000494:pharmacology*; D000818:Animals; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D011829:Radiation Dosage; D011837:Radiation-Protective Agents / Q000009:adverse effects / Q000494:pharmacology*; D012469:Salivary Glands / Q000187:drug effects* / Q000528:radiation effects*; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000532:radiotherapy*
D007457:Iodine Radioisotopes; D011837:Radiation-Protective Agents; D004999:Amifostine