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13 februari 2012: Onderaan abstract geplaatst van recentere studie welke ook aangeeft dat intraveneus amifostine - ethyol injecties de bijwerkingen van combinatie behandeling van chemo en bestraling kunnen verminderen. In dit geval bij hoofd- en halstumoren

16 maart 2006: Bron: Medscape en Int J Radiation Oncology Biol Phys 2006;64:784-791

Amifostine - Ethyol injecties vooraf gegeven aan bestraling verminderen significant de bijwerkingen van bestralen bij elke vorm van kanker blijkt uit grote overzichtstudie van 14 gerandomiseerde trials met totaal 1451 deelnemende patiënten. Vooral bij hoofd-halstumoren, strottehoofdtumoren en buiktumoren was het positieve effect extreem goed, aldus een studieverslag verspreid via Medscape. Wel hadden patiënten in de amofostinegroep 2 x zoveel last van misselijkheid, maar dit blijkt aldus de onderzoekers goed te behandelen en te onderdrukken. De kosten van amofostine zijn volgens de apotheker: ruim € 2.000,-- per 5 capsules en is dus niet bepaald een goedkoop stofje. Voor ondersteuning bij bestraling met voeding en bepaalde voedingstoffen kijkt u toch ook eens onder bestraling en voeding

Amifostine Reduces Radiotherapy Side Effects

By Will Boggs, MD

NEW YORK (Reuters Health) Mar 07 - Amifostine reduces the side effects of radiation therapy and increases complete response rates without protecting tumor cells, according to a report in the March 1 issue of International Journal of Radiation Oncology, Biology, Physics. "Amifostine has been shown to be effective and safe in order to diminish radiotherapy-related side effects, wherever the radiated area," Dr. Andre Deeke Sasse from Cidade Universitaria, Sao Paolo, Brazil told Reuters Health. Dr. Sasse and colleagues evaluated the efficacy of amifostine in diminishing radiotherapy side effects by conducting a systematic review and meta-analysis of 14 randomized controlled trials comprising 1451 patients.

In these clinical trials, amifostine consistently reduced radiotherapy-induced mucositis, esophagitis, proctitis, acute and late xerostomia, dysphagia, pneumonitis, cystitis, and dermatitis, the authors report. Complete response rates were 81% better for patients using amifostine than for other patients, the results indicate. "This fact clearly demonstrates a selectivity of protection limited to normal tissues," Dr. Sasse said. "The benefits were extensive, demonstrated for radiotherapy in head and neck, thoracic, and pelvic tumors." Relapse rates did not differ between patients using amifostine and other patients. Based on this result, the researchers conclude "that there is sufficient evidence to state that amifostine does not protect the tumor." The incidences of grade 3-4 nausea and grade 3-4 emesis were more than twice as high among patients using amifostine as among patients not using amifostine, the report indicates. Amifostine use was also associated with an increased risk for transient grade 3-4 hypotension.

"The side effects were satisfactorily controlled with regular use of antiemetic medications and usual precautions, as recommended by the manufacturer," the investigators note. "The studies that consistently showed reduction of radiotherapy-related side-effects used amifostine on a daily basis, 20 to 30 minutes before the radiation therapy, with a dosage of 500 mg/meter-squared or 340 mg/meter-squared," Dr. Sasse added. "Therefore, we recommend this therapeutic schedule."

Int J Radiation Oncology Biol Phys 2006;64:784-791.

Efficacy and safety of subcutaneous amifostine in minimizing radiation-induced toxicities in patients receiving combined-modality treatment for squamous cell carcinoma of the head and neck

Int J Radiat Oncol Biol Phys. 2007 Dec 1;69(5):1361-8. Epub 2007 Sep 14.

Efficacy and safety of subcutaneous amifostine in minimizing radiation-induced toxicities in patients receiving combined-modality treatment for squamous cell carcinoma of the head and neck.

Law A, Kennedy T, Pellitteri P, Wood C, Christie D, Yumen O.

Source

Department of Hematology/Oncology, Geisinger Medical Center, Danville, PA 17822, USA. alaw1@geisinger.edu

Abstract

PURPOSE:

To report long-term data from a prospective trial of subcutaneous (s.c.) amifostine in patients who received chemoradiotherapy for squamous cell carcinoma of the head and neck (SCCHN).

METHODS AND MATERIALS:

Patients >or=18 years of age with previously untreated Stage III/IV SCCHN received fractionated radiotherapy, 1.8-2.0 Gy/day, 5 days per week, to a total dose of 70-72 Gy, plus weekly paclitaxel (40 mg/m2) and carboplatin (100 mg/m2) administered intravenously (i.v.) for 6 weeks. All patients received 500 mg s.c. amifostine 30-60 min before radiotherapy with antihistamine and antiemetic prophylaxis.

RESULTS:

Twenty patients were evaluable (median age, 55 years). The incidence of Grade 2 xerostomia was 42% and 29% at 12 and 18 months, respectively; there were no reports of Grade >or=3 xerostomia. Grade >or=3 mucositis occurred in 30% of patients, with median time to resolution of 12.5 weeks (range, 5-17 weeks). Survival estimates at 1 and 2 years were 95% and 71%, respectively. All patients experienced Grade 2 weight loss; 7 patients (35%) experienced Grade <or=2 nausea/vomiting. There were no reports of Grade >/=3 amifostine-related adverse events.

CONCLUSIONS:

Subcutaneous amifostine was well tolerated by patients receiving chemoradiotherapy for SCCHN, with lower rates of nausea/vomiting than reported in trials with i.v. amifostine. Xerostomia and mucositis rates were similar to those reported in trials with i.v. amifostine.