Ann Clin Otolaryngol | Volume 2, Issue 2 | Review Article | Open Access
Jens Büntzel1*, Henno Welgemoed2 and Oliver Micke3
1Department of ORL, Suedharz Klinikum Nordhausen, Germany
2Clinigen Group, Burton-upon-Trent, United Kingdom
3Department of Radio oncology, Franziskus Hospital Bielefeld, Germany
*Correspondance to: Jens Büntzel
Fulltext PDFBackground: For more than half a century re-irradiation has been used as salvage treatment of recurrent head and neck cancer with reported 24-month survival rates of 30-40%. Severe acute and late toxicities are observed in up to 50% of patients limiting quality of life. Amifostine is a wellstudied selective cytoprotective agent available in clinical practice. Does amifostine represents an option to reduce toxicities in a re-irradiation setting? Material and
Methods: Data of three single centre studies with a total of 53 patients were pooled for evaluation, 42 patients received re-irradiation for head and neck cancer disease,11 had pelvic tumors (rectal cancer n = 5, cervical cancer 2, endometrial cancer 2, uterus sarcoma 1, prostate cancer 1). All head and neck cancer patients concomitantly received chemotherapy for radiosensitizing.
Results: The combination of chemo- and radiotherapy were feasible in all patients pre-treated with Amifostine 500mg with a significant reduction of grade 3 and 4 toxicities. The cumulative doses were >110 Gy for both radiotherapy courses. Acute mucosal and skin toxicities (mucositis, stomatitis, diarrhea, dermatitis, cystitis, proctitis) were reduced to grade °1/2 level in 49/53 patients. Grade 3/4 toxicities were seen in only <10% (n=4). No objective data were available for late toxicities and survival.
Conclusion: Literature to date demonstrates the potential ability of amifostine to reduce the toxicity from re-irradiation in patients with recurrent head and neck cancer as well as a small number of pelvic tumors. Further research is suggested to confirm the cytoprotective benefits of amifostine in patients receiving re-irradiation for salvage treatment
Re-irradiation; Head neck cancer; Amifostine; Cytoprotection; Salvage; Radiosensitizing
Büntzel J, Welgemoed H, Micke O. Re- Irradiation of Head and Neck Cancer: Possibilities of Cytoprotection. Ann Clin Otolaryngol. 2017; 2(2): 1014.