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Amifostene (ethyol) use in radiation therapy

justwhatiwanted
Posts: 12
Joined: Jun 2002

Hello,

I'm trying to collect information on amifostene (ethyol) use during radiation. I will be starting radiation next week, and my doctor does not want to administer the amifostene injections because "there is evidence that it may protect the cancer cells as well as the saliva glands". In doing research of my own, however, I have not found any information to this effect; rather, I have found that it is an FDA approved drug, is being tested in a multitude of clinical trials (and I have not found one stating adverse effects), and seems to be widely used for the treatment and prevention of dry mouth in radiation therapy for head and neck patients.

My question is this: what do those of you that have had radiation think of this? Has anyone else done any research on this drug? Have you found different information? If you had head/neck radiation and amifostene, what are your symptoms like? If you had radiation without amifostene, do you wish that you would have tried it? Anyone who wishes to leave their input would be greatly appreciated, as I want to feel as if I am making a sound decision on its use (or lack thereof) in my treatment.

Thank you,
Heather
schult70@msu.edu

bartora
Posts: 1
Joined: Aug 2002

Heather,

I've been following your postings on the CSN website. I'm a 40 year old male who was diagnosed in December of last year with metastatic squamous cell carcinoma. I had one swollen lymph node which was surgically removed and biopsied. Once the diagnosis was made I had to return to the hospital for a panendoscopy to locate the primary site. The primary site turned out to be my left tonsil. Two days later I underwent a modified radical neck dissection. Ten more lymph nodes were removed (all negative) and a clear margin was achieved around the initial lymph node and the left tonsil. In January I started radiation therapy and chemotherapy (cisplatin 100mg/m2, 3x at 3 week intervals). Daily radiation (38 fractions) was proceeded by amifostine treatment. Due to the short half life of amifostine, radiation has to be administered within 30 minutes of receiving the IV. Antiemitics must be administered prior to amifostine ( I received zofran (ondansetron) and steroids prior to the amifostine). Even with the antiemetics I still felt sick as a dog, usually about 45 minutes to an hour after the IV. Most of the time I'd experience a few minutes of dry heaves as I was driving home from the hospital. I didn't have any problems with the chemotherapy as far as feeling sick, just the amifostine. On the days I received chemotherapy I still had radiation therapy but I didn't get the amifostine.

My last amifostine and radiation treatment was on March 6, 2002. I did lose my voice for a few weeks because the radiation irritated (fried) my vocal cords. I did end up taking liquid hydrocodone for the pain but I never developed any mucositis. The oncologists were amazed at how well my mouth stood up to the radiation. I experienced 2 yeast infections over the period of therapy, both cases cleared up with a standard course of Diflucan. I did lose salivary function almost completely for a period of time during and probably 2 months after the radiation but afterwards I could feel that I was slowly regaining function. However, at the same time I was taking Salagen (pilocarpine hydrochloride) which is supposed to stimulate salivary flow. One side effect of this med is that it can cause your stomach to bloat. That happened to me and I found it impossible to eat because my stomach always felt full. I started losing weight and became depressed so I was started on antidepressants. Unfortunately, one of the side effects of antidepressants is dry mouth. So I'm not certain how much function I'll recover but I know it's better then it was back in March and will be even better once I'm off the antidepressants. I carry a water bottle with me wherever I go just to keep my mouth moist. But I use to wake up several times a night to drink water because my mouth was so dry and now I no longer have to do that.

Many patients who receive radiation therapy to the head and neck end up on feeding tubes. Even though my throat hurt I never had a tube inserted. I lived on fortified milkshakes for a few weeks but I could also manage some soft foods (scrambled eggs, cereal). I don't know what my salivary function would be like if I never had amifostine, but my oncologist seemed convinced it was the way to go in such a young person. I think because I was young and otherwise in perfect health there was no reason to not try and preserve my salivary glands. Many older patients would not have done as well feeling so sick each day and therefore aren't always offered the option, but I knew I'd survive the treatments and didn't want to go through life without any saliva. You need to take extra good care of your mouth during and after treatment. I undergo fluoride treatments twice a day to maintain healthy teeth.

It's been 8 months since the initial diagnosis and I feel great. I eat anything I want ( as long as I have fluid to wash it down with) and I have most of my taste back. I exercise for a half hour everyday and I am working full time. I actually think I'm in better condition then I was before I was diagnosed.

My prayers are with you,

Bob

phattpig's picture
phattpig
Posts: 29
Joined: Apr 2002

Heather,

I had my radiation in May of 2000, I had 40 radiation treatments, along with eight weeks of Cisplatin. About half way thru the radiation, I was started on the Amifostene. I received the amifostene three times a week. Every time I had the amifostene, I got sick within 10 minutes of the radiation treatment. After a couple of weeks, I convinced my doc to stop the amifostene. After I finished all of my treatments I had a problem with dry mouth, but it finally cleared up, now I have trouble with excessive thick salavia. I guess the amifostene is like the other drugs, it affects different people different ways. I hope this helps. Good luck.

John

_xia_
Posts: 16
Joined: May 2002

Hi,

I started my Radiation and Chemotherapy treatments in June 2001.

My Radiation Oncologist didn

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