Amifostine
Three studies assessed amifostine in CiO prevention. None of them found
favorable results with amifostine as a pretreatment strategy. The first
study was a randomized trial of patients with advanced ovarian cancer,
the amifostine group required less dose reduction or discontinuation of
cisplatin and reported a 43% reduction in ototoxicity incidence,
however, this difference did not reach a statistical difference (P =
0.095)(Kemp et al., 1996). The second randomized trial used a weekly
course of amifostine in patients with head and neck cancer, 21% of the
patients received concomitant radiotherapy. There was no difference in
hearing or tinnitus occurrence (P = 0.24)(Planting et al., 1999).
Lastly, in a prospective cohort of 15 patients with different types of
cancer, 11 out of 12 patients displayed auditory symptoms despite
amifostine treatment (Ekborn et al., 2004). Amifostine treatment was
poorly tolerated, all three studies report patients experienced nausea
and/or vomiting, hypotension, flushing, sneezing, dizziness, sleepiness,
hiccups, anxiety, palpitations, and chills(Kemp et al., 1996, Planting
et al., 1999, Ekborn et al., 2004).