NEW YORK (Reuters Health) – Use of the radioprotective agent amifostine to reduce xerostomia and other side effects in cancer patients undergoing radiation therapy does not decrease survival, a multicenter team reports in the Journal of Clinical Oncology online May 16.

The authors explain that concerns have been raised that cytoprotection during radiation therapy might protect not only healthy tissue but also the tumor, thus attenuating the efficacy of treatment.

To look into this issue, Dr. Jean-Pierre Pignon, with the Institut Gustave Roussy in Villejuif, France and colleagues identified 12 trials in which cancer patients treated with radiotherapy or chemoradiotherapy were randomly assigned to amifostine or not.

The 1119 patients were treated for lung cancer, head-and-neck cancer, or pelvic cancer, and the median follow-up was 5.2 years.

A meta-analysis of the data indicated that overall survival was not affected by amifostine, with a mortality hazard ratio of 0.98 for amifostine versus controls. Similarly, for progression-free survival, the hazard ratio for recurrence or death was 1.05, the researchers found.

Dr. Pignon and colleagues conclude that amifostine given concurrently with radiation therapy has “no detectable impact” on overall survival or progression-free survival.

“The reduction of radiation toxicity associated with amifostine must be weighed against the costs and adverse effects of amifostine in the context of evolving technologies and better sparing of organs at risk,” they add. “Therefore, well-designed placebo-controlled randomized trials associated with cost-benefit analyses are needed, particularly in the IMRT (intensity-modulated radiotherapy) setting, to further explore the potential benefits of amifostine.”

Reference:
Effect of Amifostine on Survival Among Patients Treated With Radiotherapy: A Meta-Analysis of Individual Patient Data
J Clin Oncol 2011;29.