Back to Journals » Lung Cancer: Targets and Therapy » Volume 9

Amifostine- and chemoradiotherapy-related esophagitis in small cell lung cancer: a single institutional series and literature update

Authors Pollock AE, Shinn L, Anderson R, Butler S, Pollock J

Received 27 October 2017

Accepted for publication 29 May 2018

Published 10 September 2018 Volume 2018:9 Pages 79—84


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Sai-Hong Ignatius Ou

Ariel E Pollock,1 Lowell Shinn,2 Richard Anderson,3 Sarah Butler,3 Jondavid Pollock3

1Department of Graduate Medical Education, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; 2Division of Medical Oncology, Schiffler Cancer Center, Wheeling Hospital, 3Division of Radiation Oncology, Schiffler Cancer Center, Wheeling Hospital, Wheeling, WV, USA

Objectives: Concurrent chemoradiotherapy is considered a standard option for patients with stage 3 small cell lung carcinoma. A 25% risk of acute esophagitis is experienced by patients as a result of the volume of esophagus encompassed within a conformal radiotherapy technique. We reviewed our institutional experience administering the radioprotectant amifostine prior to daily radiotherapy to determine its effects on the onset of esophagitis.
Materials and methods: From 2005 to 2016, 49 patients diagnosed with stage 3 small cell lung carcinoma received concurrent chemoradiotherapy. Chemotherapy (CT) consisted of cisplatin and etoposide with radiotherapy (RT) encompassing CT-identified gross tumor volume. In 32 patients (group 1), amifostine was delivered (500 mg subcutaneously divided in two injections) prior to the second daily RT fraction. The remaining 17 patients (group 2) did not receive amifostine due to choice or drug intolerance.
Results: Metrics of esophagitis included weight loss and opiate requirement during treatment. About 31% of group 1 required opiates at a median RT dose of 3300 cGy, and 41% of group 2 required opiates at a median dose of 2250 cGy. The dose of radiotherapy delivered to 50% of the esophageal volume for group 1 was significantly greater than that in group 2 (3000 cGy vs 576 cGy).
Conclusion: In this modern retrospective series of thoracic chemoradiotherapy in the treatment of stage 3 small cell lung cancer, amifostine that was delivered subcutaneously postponed the onset of esophagitis.

Keywords: small cell lung cancer, amifostine, chemoradiotherapy, esophagitis

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]