Journal ArticleDOI
Phase III Randomized Trial of Amifostine as a Radioprotector in Head and Neck Cancer
David M. Brizel,Todd H. Wasserman,Michael Henke,Vratislav Strnad,Volkar Rudat,Alain Monnier,François Eschwege,Jay Zhang,Lesley Russell,Wolfgang Oster,Rolf Sauer +10 more
TLDR
With and without amifostine, 2-year local-regional control, disease-free survival, and overall survival were 58% versus 63, 53% versus 57%, and 71% versus 66%, respectively, while Antitumor treatment efficacy was preserved.Abstract:
PURPOSE: Radiotherapy for head and neck cancer causes acute and chronic xerostomia and acute mucositis. Amifositine and its active metabolite, WR-1065, accumulate with high concentrations in the salivary glands. This randomized trial evaluated whether amifostine could ameliorate these side effects without compromising the effectiveness of radiotherapy in these patients. PATIENTS AND METHODS: Patients with previously untreated head and neck squamous cell carcinoma were eligible. Primary end points included the incidence of grade ≥ 2 acute xerostomia, grade ≥ 3 acute mucositis, and grade ≥ 2 late xerostomia and were based on the worst toxicity reported. Amifostine was administered (200 mg/m2 intravenous) daily 15 to 30 minutes before irradiation. Radiotherapy was given once daily (1.8 to 2.0 Gy) to doses of 50 to 70 Gy. Whole saliva production was quantitated preradiotherapy and regularly during follow-up. Patients evaluated their symptoms through a questionnaire during and after treatment. Local-regional c...read more
Citations
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Journal ArticleDOI
Head and neck cancer.
TL;DR: There have been important advances in understanding of the molecular pathogenesis and progression of head and neck cancer and also in approaches to therapy, which include innovations in surgery, radiation therapy, and cytotoxic-drug therapy.
Journal ArticleDOI
Preventing or reducing late side effects of radiation therapy: radiobiology meets molecular pathology.
TL;DR: Progress in molecular pathology and normal-tissue radiobiology has improved the mechanistic understanding of late normal-Tissue effects and shifted the focus from initial-damage induction to damage recognition and tissue remodelling, which stimulates research into new pharmacological strategies for preventing or reducing the side effects of radiation therapy.
Journal ArticleDOI
Effects of radiation on normal tissue: consequences and mechanisms.
TL;DR: Treatments that reduce the risk or severity of damage to normal tissue or that facilitate the healing of radiation injury are being developed, which could greatly improve the quality of life of patients treated for cancer.
Journal ArticleDOI
Clinical practice guidelines for the prevention and treatment of cancer therapy–induced oral and gastrointestinal mucositis†
Edward B. Rubenstein,Douglas E. Peterson,Mark M. Schubert,Dorothy M. K. Keefe,Deborah B. McGuire,Joel B. Epstein,Linda S. Elting,Philip C. Fox,Catherine D. Cooksley,Stephen T. Sonis +9 more
TL;DR: An expert panel was assembled to evaluate the literature and to create evidence‐based guidelines for preventing, evaluating, and treating mucositis.
Journal ArticleDOI
Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer
Avraham Eisbruch,Hyungjin Myra Kim,Jeffrey E. Terrell,Jeffrey E. Terrell,Lon H. Marsh,Laura A. Dawson,Jonathan A. Ship +6 more
TL;DR: An improvement over time in xerostomia, occurring in tandem with rising salivary production from the spared major Salivary glands, suggests a long-term clinical benefit from their sparing.
References
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