[Experiences with sodium selenite in treatment of acute and late adverse effects of radiochemotherapy of head-neck carcinomas. Cytoprotection Working Group in AK Supportive Measures in Oncology Within the scope of MASCC and DKG]

Abstract

Background: The principle of cytoprotection became a new supportive strategy in oncology during the last decade. Two principal ways of cytoprotection are well known in practice: the addition of external free thiols (for example amifostine) or the activation of internal detoxification-pathways (for example the activation of glutathione peroxidase) by administration of additional selenium.

Own experiences: We report about our experiences in both fields: At first we could show the significant possibilities of cytoprotection to reduce the acute hematological and non hematological toxicities of a simultaneous radiochemotherapy (2 cycles Carboplatin, 2 Gy single dose, 60 Gy total dose) of head and neck cancer patients. After 1 year the survival of amifostine-protected patients was better compared to the control, the rate of severe late complications (xerostomia Grade 3/4) was decreased from 57% to 14%. At second we report about the usage of selenium in the treatment of paravasats (10 patients) and interstitial lymph edema (20 patients). In the acute intervention group 9/10 patients resolved from the paravasats without any necrosis. In the late intervention group 12/20 patients showed reduced edema. Nine of 15 patients with a supraglottic edema and subsequent dyspnoea resolved under treatment without any tracheostomy.

Conclusion: On the base of these data we have planned a phase-I/II study to investigate the chances of both cytoprotectants alone and in combination in order to get the most favorable supportive regimen for our basic type of radiochemotherapy.