Sasse AD, Clark LGDO, Sasse EC, Clark OAC. Amifostine reduces side effects and improves complete response rate during radiotherapy: Results of a meta-analysis.
Int J Radiat Oncol Biol Phys 2006;
64:784-91. [PMID:
16198504 DOI:
10.1016/j.ijrobp.2005.06.023]
[Citation(s) in RCA: 149] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2005] [Revised: 06/27/2005] [Accepted: 06/28/2005] [Indexed: 11/26/2022]
Abstract
PURPOSE
To evaluate the efficacy of amifostine in diminishing radiotherapy side effects and whether or not it protects the tumor.
METHODS AND MATERIALS
We performed a systematic review and meta-analysis of 14 included randomized controlled trials, comprising 1451 patients, comparing the use of radiotherapy vs. radiotherapy plus amifostine for cancer treatment.
RESULTS
The use of amifostine significantly reduced the risk of developing mucositis (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.29-0.48; p < 0.00001), esophagitis (OR, 0.38; CI, 0.26-0.54; p < 0.00001), acute xerostomia (OR, 0.24; CI, 0.15-0.36; p < 0.00001), late xerostomia (OR, 0.33; CI, 0.21-0.51; p < 0.00001), dysphagia (OR, 0.26; CI, 0.07-0.92; p = 0.04), acute pneumonitis (OR, 0.15; CI, 0.07-0.31; p < 0.00001) and cystitis (OR, 0.17; CI, 0.09-0.32; p < 0.00001). There was no difference in overall response rate between the groups. However, complete response rate was superior for patients using amifostine (OR, 1.81; CI, 1.10-2.96; p = 0.02).
CONCLUSIONS
This systematic review shows that amifostine significantly reduces the side effects of radiation therapy. The efficacy of radiotherapy was not itself affected by the use of this drug and patients receiving amifostine were able to achieve higher rates of complete response.
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