Cetingül Nazan, Midyat Levent, Kantar Mehmet, Demirağ Bengü, Aksoylar Serap, Kansoy Savaş
Department of Pediatric Oncology, Ege University Faculty of Medicine, Izmir, Turkey.
Pediatr Blood Cancer. 2009 Jul;52(7):829-33. doi: 10.1002/pbc.21959.
Multi-systemic acute side effects occur, in response to intensive therapies that have been applied in childhood malignancies in recent years. Amifostine has rarely been used in the childhood cancers as a multisystemic protective agent for minimizing these side effects.
In this study, the effectiveness of amifostine in combination with chemotherapy for childhood cancer treatment has been researched. Of 11 subjects (2.5 months-17 years) 4 subjects had leukemia, 4 had solid tumor, and 3 had lymphoma. For these 11 subjects, 29 chemotherapy courses were given in combination with amifostine, and 20 without amifostine. Their hematological, gastrointestinal and hepatic toxicity were evaluated according to the WHO toxicity criteria. Amifostine was given intravenously in a dose of 740 mg/m(2), one to three consecutive days depending on the chemotherapy regimen.
The hemoglobin, leukocyte, and platelet levels of the two groups were not statistically different. However, when comparing the courses of the patients receiving the same medications at the same doses, in the group with amifostine, mean erythrocyte transfusion requirement was significantly reduced (P = 0.025). In 31% of the courses with amifostine and 50% of the courses without amifostine, febrile neutropenia developed. Gastrointestinal system and hepatic toxicity was significantly reduced in the courses with amifostine with respect to those without it (P = 0.001). Vomiting, hypotension and nausea were the only side effects related to amifostine.
Use of amifostine during the treatment of childhood cancers with intensive chemotherapy and/or radiotherapy significantly reduced the erythrocyte transfusion requirements of the patients as well as gastrointestinal and hepatic toxicity.
近年来，针对儿童恶性肿瘤所采用的强化治疗引发了多系统急性副作用。氨磷汀作为一种多系统保护剂，在儿童癌症中很少用于减轻这些副作用。
在本研究中，对氨磷汀联合化疗治疗儿童癌症的有效性进行了研究。11名受试者（年龄在2.5个月至17岁之间）中，4名患有白血病，4名患有实体瘤，3名患有淋巴瘤。对这11名受试者，29个化疗疗程联合使用了氨磷汀，20个化疗疗程未使用氨磷汀。根据世界卫生组织毒性标准评估他们的血液学、胃肠道和肝脏毒性。氨磷汀静脉注射剂量为740mg/m²，根据化疗方案连续给药1至3天。
两组的血红蛋白、白细胞和血小板水平无统计学差异。然而，当比较接受相同药物相同剂量治疗的患者疗程时，使用氨磷汀的组平均红细胞输血需求量显著降低（P = 0.025）。使用氨磷汀的疗程中有31%、未使用氨磷汀的疗程中有50%出现发热性中性粒细胞减少。与未使用氨磷汀的疗程相比，使用氨磷汀的疗程中胃肠道系统和肝脏毒性显著降低（P = 0.001）。呕吐、低血压和恶心是与氨磷汀相关的唯一副作用。
在儿童癌症强化化疗和/或放疗治疗期间使用氨磷汀，可显著降低患者的红细胞输血需求量以及胃肠道和肝脏毒性。
