[Outcome of primary combined radio-chemotherapy in head and neck tumors with simultaneous salivary gland protection by amifostine].

AIM: Demonstration and critical evaluation of the use of cytoprotective agents in radiation therapy.

PATIENTS AND

METHODS

In 1996 9 patients with head and neck tumors were irradiated with a mean dose of 66 Gy and simultaneous application of amifostine. Primaries were in the oropharynx (3), tongue (2), tonsils (2) as well as nasopharynx and soft palate. Parallel carboplatin was administered 6 times with a dose of 100 mg/week and amifostine twice a week with 500 mg over 6 weeks. The evaluation was performed clinically and by sialoscintigraphy (Figure 1).

RESULTS

There were no lasting side effects, but episodes of hypotension in 7 of 9 patients and nausea. Radiogenic acute toxicity was nearly uneffected, complaints from xerostomia, however, were diminished. All patients showed increased dermal pigmentation and dermatitis. Sialoscintiraphies 6 months after therapy proved better salivary gland function with correlated better patient condition.

CONCLUSION

Amifostine might gain a role in the prevention of lasting radiogenic xerostomia. The required dose is not yet clear. A broader use of amifostine would be favored by lower costs of the substance.