Amifostine for salivary glands in high-dose radioactive iodine treated differentiated thyroid cancer

source extracted confidence: high 2026-04-09
#adenocarcinoma-follicular #amifostine #carcinoma-papillary #humans #iodine-radioisotopes

Amifostine for salivary glands in high-dose radioactive iodine treated differentiated thyroid cancer

Ma et al., 2009 | Cochrane Database Syst Rev | Meta Analysis

Citation

Ma Chao, Xie Jiawei, ... Zuo Shuyao. Amifostine for salivary glands in high-dose radioactive iodine treated differentiated thyroid cancer. Cochrane Database Syst Rev. 2009-Oct-07;2009(4):CD007956. doi:10.1002/14651858.CD007956.pub2

Abstract

BACKGROUND: Radioactive iodine treatment for differentiated thyroid cancer possibly results in xerostomia. Amifostine has been used to prevent the effects of irradiation to salivary glands. To date, the effects of amifostine on salivary glands in radioactive iodine treated differentiated thyroid cancer remain uncertain. OBJECTIVES: To assess the effects of amifostine on salivary glands in high-dose radioactive iodine treated differentiated thyroid cancer. SEARCH STRATEGY: Studies were obtained from computerized searches of MEDLINE, EMBASE, The Cochrane Library and paper collections of conferences held in Chinese. SELECTION CRITERIA: Randomised controlled clinical trials and quasi-randomised controlled clinical trials comparing the effects of amifostine on salivary glands after radioactive iodine treatment for differentiated thyroid cancer with placebo and a duration of follow up of at least three months. DATA COLLECTION AND ANALYSIS: Two authors independently assessed risk of bias and extracted data. MAIN RESULTS: Two trials with 130 patients (67 and 63 patients randomised to intervention versus control) were included. Both studies had a low risk of bias. Amifostine versus placebo showed no statistically significant differences in the incidence of xerostomia (130 patients, two studies), the decrease of scintigraphically measured uptake of technetium-99m by salivary or submandibular glands at twelve months (80 patients, one study), and the reduction of blood pressure (130 patients, two studies). Two patients in one study collapsed after initiation of amifostine therapy and had to be treated by withdrawing the infusion and volume substitution. Both patients recovered without sequelae. Meta-analysis was not performed on the function of salivary glands measured by technetium-99m scintigraphy at three months after high dose radioactive iodine treatment due to the highly inconsistent findings across studies (I(2) statistic 99%). None of the included trials investigated death from any cause, morbidity, health-related quality of life or costs. AUTHORS' CONCLUSIONS: Results from two randomised controlled clinical trials suggest that the amifostine has no significant radioprotective effects on salivary glands in high-dose radioactive iodine treated differentiated thyroid cancer patients. Moreover, no health-related quality of life and other patient-oriented outcomes were evaluated in the two included trials. Randomised controlled clinical trials with low risk of bias investigating patient-oriented outcomes are needed to guide treatment choice.

Key Findings

Two trials with 130 patients (67 and 63 patients randomised to intervention versus control) were included. Both studies had a low risk of bias. Amifostine versus placebo showed no statistically significant differences in the incidence of xerostomia (130 patients, two studies), the decrease of scintigraphically measured uptake of technetium-99m by salivary or submandibular glands at twelve months (80 patients, one study), and the reduction of blood pressure (130 patients, two studies). Two patien

Outcomes Measured

  • blood pressure

Population

Field Value
Population See abstract
Sample Size 130
Age Range See abstract
Condition blood pressure

MeSH Terms

  • Adenocarcinoma, Follicular
  • Amifostine
  • Carcinoma, Papillary
  • Humans
  • Iodine Radioisotopes
  • Radiation Injuries
  • Radiation-Protective Agents
  • Radionuclide Imaging
  • Randomized Controlled Trials as Topic
  • Salivary Glands
  • Thyroid Neoplasms
  • Xerostomia

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: iodine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09