Systematic review of amifostine for the management of oral mucositis in cancer patients.
OBJECTIVE
The aim of this study was to review the available literature from 1966 until December 31, 2010 and define clinical practice guidelines for the use of amifostine for the prevention and treatment of oral mucositis in cancer patients.


METHODS
A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. The body of evidence for the use of amifostine, in each cancer treatment setting was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, or no guideline possible.


RESULTS
Thirty papers were reviewed for evidence on amifostine as an intervention for oral mucositis. No guideline was possible for amifostine in any cancer treatment setting due to inadequate and conflicting evidence.


CONCLUSIONS
Review of the amifostine studies for the prevention and treatment of oral mucositis has found insufficient evidence to support its use in any cancer treatment setting for this purpose. Additional well-designed research is needed to clarify the role of amifostine as an intervention for oral mucositis.
Dental Oncology Unit, Clinic of Hospital Dentistry, Dental School, University of Athens, Athens, Greece. nicolatou.galitis@hotmail.com
Ourania
O
Nicolatou-Galitis
Triantafyllia
T
Sarri
Joanne
J
Bowen
Mario
M
Di Palma
Vassilios E
VE
Kouloulias
Pasquale
P
Niscola
Dorothea
D
Riesenbeck
Monique
M
Stokman
Wim
W
Tissing
Eric
E
Yeoh
Sharon
S
Elad
Rajesh V
RV
Lalla
D000287:Administration, Topical; D004999:Amifostine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006801:Humans; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D017410:Practice Guidelines as Topic; D011837:Radiation-Protective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013280:Stomatitis / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*
D011837:Radiation-Protective Agents; D004999:Amifostine