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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Serious adverse effects of amifostine during radiotherapy in head and neck cancer patients.
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Serious adverse effects of amifostine during radiotherapy in head and neck cancer patients.

机译：氨磷汀在头颈癌患者放疗期间的严重不良反应。

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BACKGROUND AND PURPOSE: Amifostine has been shown to protect against xerostomia induced by radiotherapy for head and neck cancer, but its impact on the therapeutic index is unknown. This is the first report focusing on amifostine related adverse effects leading to discontinuation of amifostine treatment. PATIENTS AND METHODS: Thirty-nine patients from two centers irradiated for head and neck cancer received i.v.-infusions of amifostine prior to each radiation fraction. In a phase III study, two daily amifostine doses, 200 mg/m(2) (n = 21) and 340 mg/m(2) (n = 18), were compared for protection against radiation induced toxicity. Total radiation dose was 60-70Gy (2Gy per fraction), nine patients received concurrent chemotherapy with cisplatin/5-FU. amifostine was usually discontinued after >1 episode of serious toxicity during subsequent treatment sessions. RESULTS: In 16/39 patients (41%) amifostine was discontinued due to severe adverse effects, which led to discontinuation of the phase III study. In four of 16 patients radiotherapy was delayed due to amifostine related adverse effects for 1-3 days. Discontinuation occurred more often in patients receiving chemotherapy. The results led to a literature review for amifostine treatment during radiotherapy in head and neck cancer patients. Regarding our series and published series using an amifostine schedule comparable to ours, total discontinuation rate was 27% (57/214). Discontinuation was significantly influenced by chemotherapy (P = 0.007) but not by amifostine dose (P = 0.156). CONCLUSION: Daily i.v. administration of amifostine during radiotherapy in head and neck cancer is associated with a high rate of serious adverse effects leading to discontinuation of amifostine treatment and sometimes delay of radiotherapy.
机译：背景和目的：氨磷汀已被证明可以抵抗头颈癌放疗引起的口干症，但其对治疗指数的影响尚不清楚。这是第一个针对导致氨磷汀治疗中断的氨磷汀相关不良反应的报道。患者和方法：来自两个中心的三十九名接受过头颈癌放疗的患者在每次放疗前接受了静脉输注氨磷汀的治疗。在一项III期研究中，比较了两种每日氨磷汀剂量200 mg / m（2）（n = 21）和340 mg / m（2）（n = 18），以防止辐射引起的毒性。总放射剂量为60-70Gy（每部分2Gy），其中9例患者同时接受顺铂/ 5-FU化疗。氨磷汀通常在随后的治疗过程中> 1次严重毒性发作后停用。结果：在16/39例患者（41％）中，由于严重的不良反应而停用了氨磷汀，这导致了III期研究的中断。 16例患者中有4例由于氨磷汀相关的不良反应而推迟了1-3天的放疗。接受化疗的患者停药的发生率更高。结果导致对头颈癌​​患者放疗期间氨磷汀治疗的文献综述。关于我们的系列和使用与我们类似的氨磷汀时间表的已发表系列，总停药率为27％（57/214）。停用受到化疗的显着影响（P = 0.007），但不受氨磷汀剂量的影响（P = 0.156）。结论：每日i.v.头颈癌放疗期间服用氨磷汀与严重不良反应发生率高，导致氨磷汀治疗中断，有时放疗延迟。

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