DiPaola R S, Schuchter L
Department of Medicine, UMDNJ/Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Semin Oncol. 1999 Apr;26(2 Suppl 7):82-8.
Amifostine (Ethyol; Alza Pharmaceuticals, Palo Alto, CA/US Bioscience, West Conshohocken, PA) is a thiophosphate cytoprotectant agent with the potential to abrogate many chemotherapy-induced toxicities. In preclinical studies, amifostine protected against the cytotoxic effects of alkylating agents, platinum analogs, and radiation therapy in normal tissues, but preserved antineoplastic activity of these therapeutic modalities in tumor tissue. Most normal tissues were protected, including bone marrow, kidney, lung, and peripheral nerves. Recently, the protective effects of amifostine were confirmed by clinical studies, including a randomized trial demonstrating protection from cisplatin-induced myelosuppression, nephrotoxicity, and neurotoxicity. Many common chemotherapeutic agents, such as cisplatin, paclitaxel, and vinca alkaloids, cause dose-limiting neurotoxicity. Therefore, a neurologic protectant may help to reduce toxicity to patients, improve the tolerability of combination therapy with multiple neurotoxic agents, or allow investigators to intensify chemotherapy dose. This report reviews the potential role of amifostine as a neuroprotectant. Future clinical trials may expand the use of amifostine to abrogate neurotoxicity from multiple agents and combinations and compare amifostine with other neuroprotective agents.
氨磷汀（Ethyol；美国加利福尼亚州帕洛阿尔托的阿尔扎制药公司/美国宾夕法尼亚州西康舍霍肯的美国生物科学公司）是一种硫代磷酸酯类细胞保护剂，有可能消除多种化疗引起的毒性。在临床前研究中，氨磷汀可保护正常组织免受烷化剂、铂类类似物和放射治疗的细胞毒性作用，但能保留这些治疗方式在肿瘤组织中的抗肿瘤活性。大多数正常组织都得到了保护，包括骨髓、肾脏、肺和周围神经。最近，临床研究证实了氨磷汀的保护作用，包括一项随机试验表明其可预防顺铂引起的骨髓抑制、肾毒性和神经毒性。许多常用的化疗药物，如顺铂、紫杉醇和长春花生物碱，都会引起剂量限制性神经毒性。因此，一种神经保护剂可能有助于降低对患者的毒性，提高与多种神经毒性药物联合治疗的耐受性，或者使研究人员能够加大化疗剂量。本报告综述了氨磷汀作为神经保护剂的潜在作用。未来的临床试验可能会扩大氨磷汀的使用范围，以消除多种药物及联合用药引起的神经毒性，并将氨磷汀与其他神经保护剂进行比较。
