Amifostine for salivary glands in high-dose radioactive iodine treated differentiated thyroid cancer

Evidence Summaries

Level of Evidence = B

Amifostine appears not to have significant radioprotective effects on salivary glands in high-dose radioactive iodine treated differentiated thyroid cancer patients.

A Cochrane review 1 included 2 studies with a total of 130 subjects. Amifostine versus placebo showed no statistically significant differences in the incidence of xerostomia (130 patients, two studies), the decrease of scintigraphically measured uptake of technetium-99m by salivary or submandibular glands at twelve months (80 patients, one study), and the reduction of blood pressure (130 patients, two studies). Two patients in one study collapsed after initiation of amifostine therapy and had to be treated by withdrawing the infusion and volume substitution. Both patients recovered without sequelae. None of the included trials investigated death from any cause, morbidity, health-related quality of life or costs.

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals).

References

1. Ma C, Xie J, Chen Q, Wang G, Zuo S. Amifostine for salivary glands in high-dose radioactive iodine treated differentiated thyroid cancer. Cochrane Database Syst Rev 2009 Oct 7;(4):CD007956.  [PMID:19821441]


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