• Vassilios E Kouloulias, John R Kouvaris, John D Kokakis, Athanasios Kostakopoulos, Elias Mallas, Anna Metafa, and Lambros J Vlahos.
• Department of Radiotherapy, Areteion University Hospital of Athens, 115 Kallergi Street, GR-18544 Pireus, Greece. vkouloul@cc.ece.ntua.gr
• Int. J. Radiat. Oncol. Biol. Phys. 2004 Jul 15; 59 (4): 1148-56.

PurposeTo evaluate the cytoprotective impact of the interval between amifostine administration and radiotherapy (RT).Methods And MaterialsIn a nonrandomized study, we reviewed the records of 177 patients with tumors localized in the pelvis (prostate, bladder, or gynecologic cancer), upper abdomen (pancreas, stomach, kidney), thorax (lung and breast cancer), head and neck (nasopharynx), soft tissue (sarcomas), and central nervous system. The patient records were stratified according to whether the patients had undergone RT either 25-40 min (Group 1, 96 subjects) or 10-15 min (Group 2, 81 subjects) after i.v. amifostine administration. The mean toxicity score was the mean value of recorded acute radiation toxicity. The mean interruption time was the mean value of the recorded interruption time due to radiation toxicity.ResultsA significantly reduced severity of symptoms related to oral (p = 0.023), esophageal (p = 0.05) and rectal (p = 0.015) mucosa was noted in Group 2. A statistically significant reduction in the mean toxicity score (p <0.001) and mean interruption time (p = 0.001) was observed in Group 2 vs. Group 1. In terms of the incidence of radiation-induced dermatitis and alopecia, multivariate logistic analysis revealed only the total dose (p = 0.018) and the amifostine-RT interval (p = 0.002) as independent factors.ConclusionA significantly better cytoprotective effect of amifostine against radiation-induced mucositis, dermatitis, and alopecia was noted if RT was administered no later than 15 min after i.v. amifostine infusion. The results presented here need additional investigation with randomized prospective trials.

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