title: Meta-analysis of the efficacy of amifostine in the prevention of cisplatin ototoxicity.
abstract: OBJECTIVE
  The effectiveness of amifostine in the prevention of cisplatin ototoxicity remains controversial. The objective of this meta-analysis was to determine whether amifostine is successful in preventing ototoxicity secondary to cisplatin chemotherapy.
  
  
  METHODS
  Meta-analysis.
  
  
  METHODS
  We conducted a systematic review of all randomized, controlled trials using amifostine in patients of all ages receiving cisplatin chemotherapy. Data extraction was performed by two independent reviewers using predefined data fields, including study quality indicators. Heterogeneity was evaluated using the I2 test. The meta-analysis was performed using the random effect method.
  
  
  METHODS
  Ototoxicity.
  
  
  RESULTS
  Four randomized, controlled trials were included in this meta-analysis. The odds ratio of grade 2 or greater ototoxicity was 0.54 (95% CI 0.27-1.11), and the odds ratio of grade 3 ototoxicity or greater was 0.78 (95% CI 0.29-2.10). The side effects from amifostine use included hypocalcemia, hypotension, vomiting, and sneezing.
  
  
  CONCLUSIONS
  This meta-analysis reveals a trend toward decreased ototoxicity in patients receiving amifostine infusion prior to receiving cisplatin chemotherapy. However, the results did not reach statistical significance. Further large randomized, controlled trials of amifostine use to prevent cisplatin-induced ototoxicity are needed.
authors.affiliation: Department of Otolaryngology, University of Ottawa, Ottawa, ON.
authors.forename: Melanie
authors.initials: M
authors.lastname: Duval
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Daniel
mesh_terms: D004999:Amifostine / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D002945:Cisplatin / Q000009:adverse effects*; D004427:Ear Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy; D011837:Radiation-Protective Agents / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D011837:Radiation-Protective Agents; D004999:Amifostine; D002945:Cisplatin