Effects of amifostine on acute toxicity from concurrent chemotherapy and radiotherapy for inoperable non–small-cell lung cancer: report of a randomized comparative trial

Komaki, Ritsuko; Lee, Jin Soo; Milas, Luka; Lee, Hoon K.; Fossella, Frank V.; Herbst, Roy S.; Allen, Pamela K.; Liao, Zhongxing; Stevens, Craig W.; Lu, Charles; Zinner, Ralph; Papadimitrakopoulou, Vassiliki A.; Kies, Merrill S.; Blumenschein, George R.; Pisters, Katherine M.W.; Glisson, Bonnie S.; Kurie, Jonathan M.; Kaplan, Bünyamin; Garza, Veronica P.; Mooring, Deidre; Tucker, Susan L.; Cox, James D.

doi:10.1016/j.ijrobp.2003.10.005

Cited by 156 publications

(66 citation statements)

References 17 publications

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“…Patients on thalidomide continue with the agent as a consolidation strategy. The Radiation Therapy Oncology Group and others have evaluated the addition of amifostine to intensified concomitant chemoradiotherapy as a potential method to reduce esophagitis (41,42). Data presented here suggest no benefit from the amifostine.…”

Section: Current Trialsmentioning

confidence: 77%

Concurrent Chemoradiotherapy for Unresectable Stage III Non–Small Cell Lung Cancer

Vokes

Crawford

Socinski

et al. 2005

Clinical Cancer Research

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Over the last two decades, several approaches to multimodality therapy have been investigated in patients with advanced unresectable non^small cell lung cancer. These include induction chemotherapy and concurrent chemoradiotherapy. Both approaches have been shown to be superior to radiation therapy alone. However, in several randomized trials, concomitant chemoradiotherapy was shown to be superior to the induction chemotherapy approach. It has been hypothesized that the addition of systemic dose sequential chemotherapy to concurrent chemoradiotherapy, either as induction or as consolidation chemotherapy, might further improve survival rates. Recently, the Cancer and Leukemia Group B reported on a randomized phase III trial directly evaluating the addition of two cycles of carboplatin and paclitaxel to concurrent chemoradiotherapy. In this study, induction chemotherapy failed to further improve survival rates of concurrent chemoradiotherapy. A previously conducted randomized phase II study also suggested no benefit from the addition of induction chemotherapy to concomitant chemoradiotherapy. Favorable phase II data have been published supporting the use of consolidation chemotherapy. However, to date, no large randomized study evaluating a possible benefit from consolidation chemotherapy has been completed. In addition to evaluating optimal sequencing strategies of combined modality therapy, current investigations are also focusing on the integration of novel agents, including chemotherapeutic and targeted therapies. Currently ongoing trials involving novel approaches are reviewed here.Regionally advanced unresectable non -small cell lung cancer (NSCLC)-stage IIIA with bulky N 2 and stage IIIB (T 4 without pleural effusion or N 3 )-is characterized by large primary lesions and/or widespread involvement of the ipsilateral or contralateral mediastinum or supraclavicular regions (1). Eradication of bulky widespread disease poses a major therapeutic challenge, because radiation therapy alone can achieve locoregional control in only a small minority of such cases. In addition, patients are at high risk of distant failure due to initial micrometastatic spread (2 -6). Thus, an effective systemic therapeutic component needs to be incorporated into curative intent treatment plans. In the past, radiation therapy alone was considered standard therapy. However, 3-to 5-year survival rates achieved by single modality radiotherapy are <10%, and locoregional or systemic control is infrequently attained. As a result, combined modality approaches have been studied intensively, including sequential chemotherapy and radiotherapy (induction or consolidation) and concomitant chemoradiotherapy.From the experience of the last 20 years, it is clear that a sequential approach is mainly directed at eradication of micrometastatic disease. Induction chemotherapy, in particular, allows for early delivery of full systemic doses of chemotherapy and thus is a strategy best suited to eradicate micrometastatic disease (7 -9). Although it ...

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Section: Current Trialsmentioning

confidence: 77%

Concurrent Chemoradiotherapy for Unresectable Stage III Non–Small Cell Lung Cancer

Vokes

Crawford

Socinski

et al. 2005

Clinical Cancer Research

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“…[29] This finding does not parallel to the author's previous finding and opposes the finding of another study by Komaki et al Former one suggested amifostine reduced the incidence and severity of acute and late toxicities in general but specifically for dysgeusia were not very striking; later one showed the dysgeusia was more frequent among patients given amifostine. [52,53] Other studies were not clear on the effect on dysgeusia. [54] Use of megestrol acetate (MA) is not frequently studied, the presented study by Erkurt et al supports the positive outcome on dysgeusia, but the study has several limitations to prevent it from generalisation.…”

Section: Discussionmentioning

confidence: 99%

Management of Dysgeusia related to Cancer

Munankarmi

2017

J Lumbini Med Coll

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a ----------------------------------------------- ABSTRACT:Introduction: Taste change due to cancer is a notorious side effect, adversely affecting appetite and weight. Even though taste change or dysgeusia is one of the major causes of poor nutritional status in cancer survivors, it is not addressed as a significant problem and is often left untreated. The main purpose of this review is to explore current knowledge of pharmacological and behavioral interventions for the treatment of cancer related taste change. Methods: This systematic review was conducted in accordance with PRISMA guidelines to identify original articles on taste change. Multiple databases including; Scopus, Medline, EMBASE, CINAHL, and all databases via Pro quest were searched for original articles or studies related to taste change caused by cancer or its treatment. Relevant articles were subjected to a full text evaluation and assessed by Critical appraisal skills program (CASP) guidelines and the Effective public health practice project (EPHPP) instrument. Results: The search revealed 12 eligible studies, six of which were randomized controlled trials. Most of the studies used a standardized validated tool to measure taste change. Dysgeusia is common in cancer, 14 to 100% cancer patient report it. Pharmacological management with zinc remains inconclusive as one study reports it as beneficial and two other studies reported null effect. Few studies suggested dietary modifications such as use of sugary, salty foods that are helpful to reduce the effect of dysgeusia. Conclusion: Dietary counseling and informing the patient well about self-care strategies before treatment has consistently shown positive results on taste change, with strong statistical power. Other potential treatments for dysgeusia such as zinc, amifostine, and megestrol acetate gave inconsistent results.

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“…Patients in the study group received amifostine, 500 mg i.v., twice weekly before chemoradiation, and patients in the control group received chemoradiation without Amifostine (Komaki et al, 2004). The median survival time was longer, but not significantly so, for patients receiving amifostine (26 months versus 15 months).…”

Section: Esophagitis and Pneumonitismentioning

confidence: 99%