Jens Büntzel

Radiochemotherapy with amifostine cytoprotection for head and neck cancer

Abstract A randomized study was conducted to evaluate the protective activity of amifostine (A) against the dose-limiting toxicities of radiochemotherapy (RCT). Patients with head and neck cancer received radiotherapy (2 Gy/day 5 days a week up to 60 Gy) with carboplatin 70 mg/m2 on days 1–5 and 21–25 inclusive. Patients either received RCT alone (n=14) or RCT+A at a dose of 500 mg prior to treatment with carboplatin (n=25). There was a significant reduction in the incidence of grade 3/4 mucositis (P<0.0001), acute grade 2 xerostomia (P<0.0001) and grade 3/4 thrombocytopenia (P=0.012) in these patients who received A. The incidence of grade 2 late xerostomia at 12 months is 16.7% and the incidence of loss of taste is 0% in patients treated with A, as opposed to 54.5% and 63.6% in patients who received RCT alone. There were 18 (72%) complete responses (CR) and 6 (24%) partial responses (PR) in patients who received A, compared with 6 (43%) CR and 6 PR (43%) in patients treated with RCT alone. The disease-free survival at 12 months is 85.7% in the RCT+A arm and 78.6% in the RCT alone arm. The use of amifostine reduces the incidence and severity of acute and late toxicities associated with RCT whilst preserving antitumour activity.

Economic analysis of amifostine as adjunctive support for patients with advanced head and neck cancer: preliminary results from a randomized phase II clinical trial from Germany.

In a randomized phase II trial in Germany, we investigated the clinical and economic impact of amifostine protection against the hematological and oral toxicities of carboplatin administered concurrently with standard fractions of radiotherapy. 28 patients with squamous cell carcinomas of the head and neck received adjunctive or primary radiotherapy (5 days per week with daily fractions of 2 Gy, up to a total dose of 60 Gy) in conjunction with carboplatin (70 mg/m2) on days 1–5 and days 21–26. All patients received radiation encompassing at least 75% of the major salivary glands. Patients were randomized to receive radiation and carboplatin (RCT) alone or RCT preceded by rapid infusion of amifostine (500 mg) on days carboplatin was administered. The 14 patients who received amifostine, in comparison to 14 patients in the control arm, had significantly fewer episodes of grade 3 or 4 thrombocytopenia (p = 0.001), mucositis (p = 0.001), and xerostomia (p = 0.001). The patients receiving amifostine accrued significantly lower supportive care costs for resources related to infection (

High-dose-rate brachytherapy in the treatment of recurrent and residual head and neck cancer

241 vs.

Radiotherapy in langerhans cell histiocytosis - a rare indication in a rare disease.

1,275, p < 0.01), red blood cell and platelet support (

Complementary and alternative medicine experience in radiation oncology patients : first results of a multi-center approach

286 vs.

Chemoprevention with interferon alfa and 13-cis retinoic acid in the adjunctive treatment of head and neck cancer

1,276 p = 0.06) alimentation (

Surgery and radiotherapy of one rare case with neoplasm derived from fibroblastic reticulum cells of a cervical lymph node.

343 vs.

Selective Cytoprotection with Amifostine: A New Strategy in Supportive Care of Head and Neck Malignancies

894, p =. 01), and hospitalization (

Integrative Behandlungsansätze in der Palliativmedizin

286 vs.

Amifostine in Simultaneous Radiochemotherapy for Head and Neck Cancer

2,429, p < 0.01). Overall, including the costs of amifostine, mean per patient supportive care costs were