Document Detail


Amifostine and curative intent chemoradiation for compromised cancer patients.
MedLine Citation:
PMID:  12820436     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Concurrent chemotherapy and radiation are usually indicated for locally advanced carcinomas such as head and neck and anal malignancies. Because of the toxicity of the treatment, patient selection plays an important role in recommendations to treat with a curative intent. Elderly patients (> 70 years), those with underlying medical conditions or acquired immunological disorders (AIDS) are commonly excluded from combined modality therapy because of their perceived inability to tolerate the aggressive treatment. They may thus be deprived of a potentially curative therapy. In an attempt to improve outcome, we conducted a pilot study using amifostine, a radioprotector, to increase the tolerance of such compromised individuals to treatment. Amifostine (500 mg intravenously) was given during chemotherapy on days 1-5, and days 21-25 of radiation regimen. All patients were able to complete the chemoradiation. Despite the locally advanced stage of the disease, five out of our six patients achieved a complete response (CR). One patient with synchronous primaries had a complete response for the base of tongue cancer and regression of the esophageal cancer, which allowed him to resume oral feeding. All patients achieved improved quality of life. Successful chemoradiation appears to be feasible in patients with advanced stage, age and/or underlying medical conditions when amifostine is integrated in the treatment.
Authors:
Nam P Nguyen; Barry Levinson; Suresh Dutta; Ulf Karlsson; Kevin C Kelly; Jonathan Dowell; Adir Ludin; Sabah Sallah
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Anticancer research     Volume:  23     ISSN:  0250-7005     ISO Abbreviation:  Anticancer Res.     Publication Date:    2003 Mar-Apr
Date Detail:
Created Date:  2003-06-24     Completed Date:  2003-07-10     Revised Date:  2006-04-24    
Medline Journal Info:
Nlm Unique ID:  8102988     Medline TA:  Anticancer Res     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  1649-56     Citation Subset:  IM    
Affiliation:
Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, VA North Texas Health Care System, 4500 S Lancaster Road, Dallas, TX 75216, USA. NamPhong.Nguyen@med.va.gov
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / complications*
Aged
Aged, 80 and over
Amifostine / therapeutic use*
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Anus Neoplasms / complications,  drug therapy*,  radiotherapy*
Cisplatin / administration & dosage
Combined Modality Therapy
Fluorouracil / administration & dosage
Head and Neck Neoplasms / complications,  drug therapy*,  radiotherapy*
Humans
Male
Middle Aged
Pilot Projects
Radiation-Protective Agents / therapeutic use*
Chemical
Reg. No./Substance:
0/Radiation-Protective Agents; 15663-27-1/Cisplatin; 20537-88-6/Amifostine; 51-21-8/Fluorouracil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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