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Amifostine Offers Little Advantage in Small Trial of Twice-Daily Radiation Plus Chemotherapy

Amifostine Offers Little Advantage in Small Trial of Twice-Daily Radiation Plus Chemotherapy

ST LOUIS—In a small phase II study, amifostine (Ethyol) provided
little advantage in esophageal protection for patients with limited-stage
small-cell lung cancer (SCLC) treated with chemotherapy and twice-daily
radiation. Results of the trial were reported by Todd H. Wasserman, MD. Dr.
Wasserman is professor of radiation oncology and clinical chief, Department
of Radiation Oncology, Washington University Medical Center, St. Louis.

"We entered 34 patients into a limited phase II trial with
small-cell lung cancer. This study used BID radiation with etoposide
(VePesid) and cisplatin (Platinol) and amifostine at 340 mg/m² IV," Dr.
Wasserman said.

Data from this study were compared to historical controls reported by
Turrisi et al (N Engl J Med 340:265-271, 1999). That study compared
esophagitis in 417 patients receiving BID vs QD radiation. 

The Turrisi study also found that BID radiation plus chemotherapy
resulted in better survival.

Similar Esophagitis Rates

In the study reported by Dr. Wasserman, all patients completed radiation,
and 26 had the four cycles of chemotherapy. Others had fewer cycles of
chemotherapy because of toxicity.

Amifostine was well tolerated and toxicities attributable to it were
mild. "We had one rash, a delayed-type hypersensitivity reaction,"
Dr. Wasserman noted. "We had nausea and vomiting in 32%, and
hypotension in 30%."

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