Tannehill S P, Mehta M P
Department of Human Oncology, University of Wisconsin Medical School, Madison 53792-0600, USA.
Semin Oncol. 1996 Aug;23(4 Suppl 8):69-77.
Preclinical studies demonstrate that amifostine has the potential to selectively protect normal tissues from the harmful effects of radiation without significantly protecting neoplastic tissue. The potential value of such an agent includes reducing treatment-related toxicity and the opportunity for radiation dose escalation in the curative treatment of cancer. An increasing number of human clinical trials have been conducted that define the toxicity profile and efficacy of radioprotection by amifostine when used during fractionated radiation therapy. These trials demonstrate that amifostine is safe and practical to administer in the outpatient setting during fractionated radiation therapy. These studies also illustrate the challenge of accurately evaluating the end point of radioprotection in the clinical setting. This article reviews the recent clinical literature on amifostine, the evidence for normal tissue protection, and the lack of tumor protection by this agent, and suggests possible avenues for future investigation and application of this agent in the field of radiation oncology.
临床前研究表明，氨磷汀有潜力选择性地保护正常组织免受辐射的有害影响，而对肿瘤组织的保护作用不显著。这类药物的潜在价值包括降低治疗相关毒性以及在癌症根治性治疗中提高放射剂量的机会。越来越多的人体临床试验已经开展，这些试验明确了在分次放射治疗期间使用氨磷汀进行放射防护的毒性特征和疗效。这些试验表明，在分次放射治疗期间，氨磷汀在门诊环境中给药是安全且实用的。这些研究还说明了在临床环境中准确评估放射防护终点所面临的挑战。本文回顾了关于氨磷汀的近期临床文献、正常组织保护的证据以及该药物缺乏肿瘤保护作用的情况，并提出了该药物在放射肿瘤学领域未来研究和应用的可能途径。
