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Does amifostine have radioprotective effects on salivary glands in high-dose radioactive iodine-treated differentiated thyroid cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Objectives

To assess the effects of amifostine on salivary glands in radioactive iodine-treated differentiated thyroid cancer.

Methods

We searched the MEDLINE, EMBASE and the Cochrane Library for randomized controlled clinical trials which compared the effects of amifostine with those of placebo or acid-stimulating agents.

Results

Two randomized controlled clinical trials with a total of 130 patients were included. Both studies had a low risk of bias. There were no statistically significant differences between the effects of amifostine and acid-stimulating agents on the incidence of xerostomia (RR 0.24, 95% CI 0.01 to 9.52), the decrease of scintigraphically measured uptake of 99mTc by the parotid (RR 0.30, 95% CI −2.28 to 2.88) or submandibular glands (RR 1.90, 95% CI -1.46 to 5.26) at 12 months, or the reduction in blood pressure (RR 5.00, 95% CI 0.25 to 99.16). Neither of the included trials investigated death from any cause, morbidity, health-related quality of life or costs.

Conclusion

The results of two randomized controlled clinical trials suggest that amifostine has no significant radioprotective effects on salivary glands in radioactive iodine treatment of differentiated thyroid cancer. The use of acid-stimulating agents to increase salivation should remain the first choice during radioactive iodine treatment of differentiated thyroid cancer. Patients should also be well informed of the importance of hydration and acid stimulation.

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Acknowledgments

We would like to acknowledge Gudrun Paletta and Karla Bergerhoff of the Cochrane Metabolic and Endocrine Disorders group for their comments and advice during the preparation of this review. This study was supported by the National Science Fund (no. 30700185).

Author contributions

M.C. and X.J.W. independently scanned the abstract, title or both sections of every record retrieved and drafted the manuscript. Z.J. and G.W. did the research and statistical analysis. S.Z. participated in the design of the study and helped to draft the manuscript. All authors read and approved the final draft.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Affiliated Hospital, Medical College, Qingdao University, Qingdao, Shandong Province, China, 266003

    Chao Ma, Guoming Wang & Shuyao Zuo

  2. Medical College, Qingdao University, Qingdao, China

    Jiawei Xie

  3. Affiliated Hospital, Medical College, Qingdao University, Qingdao, China

    Zhongxin Jiang

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  1. Chao Ma
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Correspondence to Chao Ma.

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Ma, C., Xie, J., Jiang, Z. et al. Does amifostine have radioprotective effects on salivary glands in high-dose radioactive iodine-treated differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 37, 1778–1785 (2010). https://doi.org/10.1007/s00259-009-1368-6

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  • DOI: https://doi.org/10.1007/s00259-009-1368-6

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