Article
Late toxicities in head and neck cancer patients. Influence of cytoprotection ?
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Published: | March 20, 2006 |
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Objective: We analyzed the late toxicities due to multimodal therapy of advanced head and neck cancers. The impact of cytoprotection with amifostine is the specific objective of this report.
Methods: We included851consultations (233 persons, 39 felmale, 194 male, mean age 60,9 +/- 9,9 years) with head and neck cancer into this prospective study. 458/851 had received amifostine before radio(chemo)therapy,393 control subjects had not got any kind of cytoprotection before irradiation. A primary radiochemotherapy was performed in283 patients, an adjuvant radiation was administered in568 patients. The follow-up examination was done at our out-door departmentsat median 643days (range 69-4468) after the primary therapy.
Results: Late xerostomia was seen in 770(851 patients. Altered taste was reported by 284/851. During the first year both reactions weresignificantly reduced (Xerostomia p=0,046, loss of taste p=0,04)by amifostine support in basic treatment.Fibrotic tissue reactions (e.g. cervical esophageal stenosis)were registered in 174/851 patients.Interstitial lymph edema occured in 412/851 subjects. No improvement was observed due to cytoprotection. Secondary symptoms like posttreatment pain (107 pts.) or dysphagia (670 pts.) were also reduced signicantly.
Conclusions: The administration of amifostine has reduced selected toxicities (xerostomia, loss of taste) during the first year. This transient effectwas not seen in typical longtimetoxicities as lymphedema and fibrotic tissue reactions.