Findings

What do systematic reviews say?

35 questions · 39 findings · 2 reviews · Oral medicine and oral cancer

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No studies found 3 · 7.7%GRADE not reported 24 · 61.5%Very low 4 · 10.3%Low 7 · 17.9%Moderate 1 · 2.6%High 0 · 0%

Amifostine vs placebo/no treatment

Oral mucositis (any severity) · Patients with cancer receiving radiotherapy, chemotherapy or targeted therapies

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

1 finding from 1 review

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

Oral mucositis (severe) · Patients with cancer receiving radiotherapy, chemotherapy or targeted therapies

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

1 finding from 1 review

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)

Locoregional control · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

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

1 finding from 1 review

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)

Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

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)

Adverse effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

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)

Overall survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

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

1 finding from 1 review

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)

Quality of life · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

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)

Xerostomia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

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

2 findings from 1 review

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

Survival (overall survival and locoregional control) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

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

Allergic adverse events · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

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.

1 finding from 1 review

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

Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

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

Nausea · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

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.

1 finding from 1 review

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

Xerostomia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

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.

1 finding from 1 review

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

Vomiting · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

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.

1 finding from 1 review

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

Quality of life · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

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