What do systematic reviews say?

Amifostine vs placebo/no treatment

Amifostine probably leads to lower oral mucositis (any severity) compared with placebo/no treatment (moderate certainty).

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.95 [0.91, 0.99]
  3 studies · 430 participants
  Moderate

Amifostine vs placebo/no treatment

It is very uncertain whether amifostine changes oral mucositis (severe) compared with placebo/no treatment (very low certainty).

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.68 [0.45, 1.03]
  9 studies · 845 participants
  Very low

Amifostine (intravenous) vs Amifostine (subcutaneous)

Amifostine (intravenous) showed no clear difference in locoregional tumour control compared with amifostine (subcutaneous); GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  48 months postRT
  HR 1.34 [0.76, 2.36]
  1 study
  GRADE not reported

Amifostine (intravenous) vs Amifostine (subcutaneous)

The review found no eligible studies for this question.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  No salivary flow rate data related to routes of administration of amifostine were reported.
  0 studies
  No studies found

Amifostine (intravenous) vs Amifostine (subcutaneous)

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  Increased hypotension with intravenous delivery (20% vs 8%; P = 0.007); skin rash (10% vs 22%; P = 0.012) and local pain at injection site (0% vs 8%; P = 0.001) worse with subcutaneous; inconclusive for…
  1 study
  GRADE not reported

Amifostine (intravenous) vs Amifostine (subcutaneous)

Amifostine (intravenous) showed no clear difference in overall survival compared with amifostine (subcutaneous); GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  48 months postRT
  HR 1.36 [0.89, 2.10]
  1 study
  GRADE not reported

Amifostine (intravenous) vs Amifostine (subcutaneous)

The review found no eligible studies for this question.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  No data on either quality of life or other oral related symptoms were reported.
  0 studies
  No studies found

Amifostine (intravenous) vs Amifostine (subcutaneous)

Amifostine (intravenous) led to lower xerostomia (grade >= 2, 0-4 scale) compared with amifostine (subcutaneous); GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  12 months postRT
  RR 0.61 [0.42, 0.88]
  1 study · 127 participants
  GRADE not reported
• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  Up to and including 3 months postRT
  RR 1.03 [0.76, 1.40]
  1 study · 263 participants
  GRADE not reported

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  Insufficient evidence reported on overall survival or locoregional tumour control (Analysis 4.2; 4.3)
  1 study
  GRADE not reported

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

Amifostine 200 mg/m2 three times weekly showed no clear difference in allergic response (adverse effect) compared with amifostine 200 mg/m2 five times weekly; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  RR 1.00 [0.15, 6.64]
  1 study · 60 participants
  GRADE not reported

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

The review found no eligible studies for this question.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  No salivary flow rate data related to the effectiveness of different doses of amifostine were reported.
  0 studies
  No studies found

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

Amifostine 200 mg/m2 three times weekly showed no clear difference in nausea (adverse effect) compared with amifostine 200 mg/m2 five times weekly; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  RR 0.64 [0.33, 1.25]
  1 study · 60 participants
  GRADE not reported

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

Amifostine 200 mg/m2 three times weekly showed no clear difference in xerostomia (grade >= 2, 0-4 scale) compared with amifostine 200 mg/m2 five times weekly; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  12 months postRT
  RR 0.94 [0.58, 1.53]
  1 study · 49 participants
  GRADE not reported

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

Amifostine 200 mg/m2 three times weekly showed no clear difference in vomiting (adverse effect) compared with amifostine 200 mg/m2 five times weekly; GRADE not reported.

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
  RR 0.25 [0.06, 1.08]
  1 study · 60 participants
  GRADE not reported

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

• Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes

  End of RT and 6, 12, 18, 24 months postRT
  No significant differences between the three treatment arms (Jellema 2006)
  1 study
  GRADE not reported

Amifostine vs no intervention

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Amifostine vs no intervention

Summary of findings: Amifostine may leads to lower acute and late GI toxicity (grade 2+) compared with no intervention (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.25
  3 studies · 278 participants
  Low

Amifostine vs no intervention

It is very uncertain whether summary of findings: Amifostine changes diarrhoea (grade 2+) during treatment compared with no intervention (very low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.25 [0.06, 0.98]
  1 study · 36 participants
  Very low

Amifostine vs no intervention

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found