Intrarectal amifostine suspension may protect against acute proctitis during radiation therapy for prostate cancer: A pilot study

Anurag K. Singh, Cynthia Ménard, Peter Guion, Nicole L. Simone, Sharon Smith, Nancy Sears Crouse, Denise J. Godette, Theresa Cooley-Zgela, Linda C. Sciuto, Jonathan Coleman, Peter Pinto, Paul S. Albert, Kevin Camphausen, C. Norman Coleman

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Purpose: Our goal was to test the ability of intrarectal amifostine to limit symptoms of radiation proctitis. Methods and Materials: The first 18 patients received 1 g of intrarectal amifostine suspension placed 30-45 min before each radiation treatment. The following 12 patients received 2 g of amifostine. Total dose prescribed ranged from 66 to 76 Gy. All patients were treated with three-dimensional conformal radiation therapy. The suspension remained intrarectal during treatment and was expelled after treatment. For gastrointestinal symptoms, during treatment and follow-up, all patients had a Radiation Therapy Oncology Group (RTOG) grade recorded. Results: Median follow-up was 18 months (range, 6-24 months). With 2 g vs. 1 g amifostine, there was a nearly significant decrease in RTOG Grade 2 acute rectal toxicity. Seven weeks after the start of radiation therapy, the incidence of Grade 2 toxicity was 33% in the 1-g group (6/18) compared with 0% (0/12) in the 2-g group (p = 0.06). No Grade 3 toxicity or greater occurred in this study. Conclusion: This trial suggests greater rectal radioprotection from acute effects with 2 g vs. 1 g amifostine suspension. Further studies should be conducted in populations at higher risk for developing symptomatic acute and late proctitis.

Original languageEnglish (US)
Pages (from-to)1008-1013
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume65
Issue number4
DOIs
StatePublished - Jul 15 2006
Externally publishedYes

Keywords

  • Amifostine
  • Intrarectal
  • Proctitis
  • Prostate
  • Radiation

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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