Amifostine- and chemoradiotherapy-related esophagitis in small cell lung cancer: a single institutional series and literature update

Ariel E Pollock,1 Lowell Shinn,2 Richard Anderson,3 Sarah Butler,3 Jondavid Pollock3 1Department of Graduate Medical Education, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; 2Division of Medical Oncology, Schiffler Cancer Center, Wheeling Hospital, 3Division of Radiation Oncology, Schiff...

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Autores principales:	Pollock AE, Shinn L, Anderson R, Butler S, Pollock J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Small cell lung cancer amifostine chemoradiotherapy esophagitis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/410a5863f07a46f18737f090165f9a39
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spelling	oai:doaj.org-article:410a5863f07a46f18737f090165f9a392021-12-02T05:16:27ZAmifostine- and chemoradiotherapy-related esophagitis in small cell lung cancer: a single institutional series and literature update1179-2728https://doaj.org/article/410a5863f07a46f18737f090165f9a392018-09-01T00:00:00Zhttps://www.dovepress.com/amifostine--and-chemoradiotherapy-related-esophagitis-in-small-cell-lu-peer-reviewed-article-LCTThttps://doaj.org/toc/1179-2728Ariel E Pollock,1 Lowell Shinn,2 Richard Anderson,3 Sarah Butler,3 Jondavid Pollock3 1Department of Graduate Medical Education, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; 2Division of Medical Oncology, Schiffler Cancer Center, Wheeling Hospital, 3Division of Radiation Oncology, Schiffler Cancer Center, Wheeling Hospital, Wheeling, WV, USA Objectives: Concurrent chemoradiotherapy is considered a standard option for patients with stage 3 small cell lung carcinoma. A 25% risk of acute esophagitis is experienced by patients as a result of the volume of esophagus encompassed within a conformal radiotherapy technique. We reviewed our institutional experience administering the radioprotectant amifostine prior to daily radiotherapy to determine its effects on the onset of esophagitis. Materials and methods: From 2005 to 2016, 49 patients diagnosed with stage 3 small cell lung carcinoma received concurrent chemoradiotherapy. Chemotherapy (CT) consisted of cisplatin and etoposide with radiotherapy (RT) encompassing CT-identified gross tumor volume. In 32 patients (group 1), amifostine was delivered (500 mg subcutaneously divided in two injections) prior to the second daily RT fraction. The remaining 17 patients (group 2) did not receive amifostine due to choice or drug intolerance. Results: Metrics of esophagitis included weight loss and opiate requirement during treatment. About 31% of group 1 required opiates at a median RT dose of 3300 cGy, and 41% of group 2 required opiates at a median dose of 2250 cGy. The dose of radiotherapy delivered to 50% of the esophageal volume for group 1 was significantly greater than that in group 2 (3000 cGy vs 576 cGy). Conclusion: In this modern retrospective series of thoracic chemoradiotherapy in the treatment of stage 3 small cell lung cancer, amifostine that was delivered subcutaneously postponed the onset of esophagitis. Keywords: small cell lung cancer, amifostine, chemoradiotherapy, esophagitisPollock AEShinn LAnderson RButler SPollock JDove Medical PressarticleSmall cell lung canceramifostinechemoradiotherapyesophagitisNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENLung Cancer: Targets and Therapy, Vol Volume 9, Pp 79-84 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Small cell lung cancer amifostine chemoradiotherapy esophagitis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Small cell lung cancer amifostine chemoradiotherapy esophagitis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Pollock AE Shinn L Anderson R Butler S Pollock J Amifostine- and chemoradiotherapy-related esophagitis in small cell lung cancer: a single institutional series and literature update
description	Ariel E Pollock,1 Lowell Shinn,2 Richard Anderson,3 Sarah Butler,3 Jondavid Pollock3 1Department of Graduate Medical Education, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; 2Division of Medical Oncology, Schiffler Cancer Center, Wheeling Hospital, 3Division of Radiation Oncology, Schiffler Cancer Center, Wheeling Hospital, Wheeling, WV, USA Objectives: Concurrent chemoradiotherapy is considered a standard option for patients with stage 3 small cell lung carcinoma. A 25% risk of acute esophagitis is experienced by patients as a result of the volume of esophagus encompassed within a conformal radiotherapy technique. We reviewed our institutional experience administering the radioprotectant amifostine prior to daily radiotherapy to determine its effects on the onset of esophagitis. Materials and methods: From 2005 to 2016, 49 patients diagnosed with stage 3 small cell lung carcinoma received concurrent chemoradiotherapy. Chemotherapy (CT) consisted of cisplatin and etoposide with radiotherapy (RT) encompassing CT-identified gross tumor volume. In 32 patients (group 1), amifostine was delivered (500 mg subcutaneously divided in two injections) prior to the second daily RT fraction. The remaining 17 patients (group 2) did not receive amifostine due to choice or drug intolerance. Results: Metrics of esophagitis included weight loss and opiate requirement during treatment. About 31% of group 1 required opiates at a median RT dose of 3300 cGy, and 41% of group 2 required opiates at a median dose of 2250 cGy. The dose of radiotherapy delivered to 50% of the esophageal volume for group 1 was significantly greater than that in group 2 (3000 cGy vs 576 cGy). Conclusion: In this modern retrospective series of thoracic chemoradiotherapy in the treatment of stage 3 small cell lung cancer, amifostine that was delivered subcutaneously postponed the onset of esophagitis. Keywords: small cell lung cancer, amifostine, chemoradiotherapy, esophagitis
format	article
author	Pollock AE Shinn L Anderson R Butler S Pollock J
author_facet	Pollock AE Shinn L Anderson R Butler S Pollock J
author_sort	Pollock AE
title	Amifostine- and chemoradiotherapy-related esophagitis in small cell lung cancer: a single institutional series and literature update
title_short	Amifostine- and chemoradiotherapy-related esophagitis in small cell lung cancer: a single institutional series and literature update
title_full	Amifostine- and chemoradiotherapy-related esophagitis in small cell lung cancer: a single institutional series and literature update
title_fullStr	Amifostine- and chemoradiotherapy-related esophagitis in small cell lung cancer: a single institutional series and literature update
title_full_unstemmed	Amifostine- and chemoradiotherapy-related esophagitis in small cell lung cancer: a single institutional series and literature update
title_sort	amifostine- and chemoradiotherapy-related esophagitis in small cell lung cancer: a single institutional series and literature update
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/410a5863f07a46f18737f090165f9a39
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Amifostine- and chemoradiotherapy-related esophagitis in small cell lung cancer: a single institutional series and literature update

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