Effect of Amifostine to prevent Radiotherapy-Induced Acute and Late Toxicity in Head and Neck Cancer Patients Who had Normal or Mild Impaired Salivary Gland Function
Vutisiri Veerasarn MD*, Pramook Phromratanapongse MD**, Nan Suntornpong MD*, Vicharn Lorvidhaya MD***, Vimol Sukthomya MD***, Imjai Chitapanarux MD***, Chanawat Tesavibul MD**, Thiti Swangsilpa MD**, Cholakiet Khorprasert MD****, Kanjana Shotelersuk MD****, Yongyut Kongthanarat MD*****, Apichart Panichevaluk MD*****, Sunanta Chiewvit MD******, Pawana Pusuwan MD******, Monreudee Aekmahachai MD*******, Samart Ratchadara MD********, Sasitorn Sirilipoche MD*********, Yuttana Saengsuda MD**********
Affiliation : * Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok ** Division of Radiation Oncology, Department of Radiology, Pramongkutklao Hospital, Bangkok *** Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai **** Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok ***** Division of Radiation Oncology, Department of Radiology, Rajavithi Hospital, Bangkok ****** Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok ******* Division of Nuclear medicine, Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai ******** Division of Nuclear Medicine, Department of Radiology, Pramongkutklao Hospital, Bangkok ********* Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok **********Division of Nuclear Medicine, Department of Radiology, Rajavithi Hospital, Bangkok
Background : Amifostine has a potential role for salivary gland protection in head and neck cancer patients
who had radiotherapy.
Materials and Methods : Sixty-seven head and neck cancer patients were randomized to receive radiotherapy
or radiotherapy plus Amifostine. The efficacy of the treatment was determined by a questionnaire evaluating
dryness of mouth and the oral comfort, the RTOG/EORTC acute/late radiation morbidity scoring criteria,
collection of the whole saliva and the 99mTc-pertecnetate scintigraphy of the salivary glands.
Results : Amifostine significantly reduced the mean questionnaire scores from 6.49 to 3.73, the incidence of
grade > 2 mucositis from 75% to 36% and acute xerostomia from 82% to 39%. The salivary gland function
returned to normal at a rate of 36.3% in the Amifostine group versus 9.1% in the control group.
Conclusion : Amifostine is effective in reducing the incidence and severity of acute mucositis, acute and late
xerostomia in head and neck cancer patients.
Keywords : Head and neck cancer, Radiotherapy, Amifostine, Mucositis, Xerostomia
