The role of amifostine in the treatment of carcinoma of the uterine cervix: an update of RTOG-0116 and review of future directions

Abstract

Approximately 10,520 women will be diagnosed with carcinoma of the uterine cervix in 2004, resulting in significant mortality. While definitive or adjuvant radiation therapy remains a critical component of treatment, both local and distant recurrences may occur. The recent addition of chemotherapy has helped reduce these recurrences and improve survival, albeit at a cost of increased toxicity, especially in patients requiring extended-field treatment. New agents, such as amifostine (Ethyol, MedImmune Inc, Gaithersburg, MD), that possess cytoprotective and radioprotective properties may help ameliorate toxicity. This report reviews and updates the rationale and current experience with amifostine in the treatment of carcinoma of the uterine cervix. Data suggest a benefit in patients with pelvic malignancies receiving amifostine before either chemotherapy or radiation, and that subcutaneous administration may be as efficacious and less toxic than the intravenous route. Ongoing trials will likely provide more data to the role of amifostine in the treatment of carcinoma of the uterine cervix, and especially whether the administration of subcutaneous amifostine before both chemotherapy/radiation therapy will translate into a reduction in acute and late toxicity.