Abstract
BACKGROUND: Controversy exists on whether amifostine can reduce the efficacy and decrease the side effects of non-small cell lung cancer (NSCLC) treated by radiotherapy. The aim of this meta-analysis is to evaluate the efficacy and side effects of amifostine in NSCLC patients treated with radiotherapy. METHODS: Open published randomized controlled trials on the efficacy and side effects of amifostine in NSCLC patients treated with radiotherapy were collected from Medline, Cochrane Central Register of Controlled Trials, EMBSE, CBM, CNKI, WANFANG, American Society of Clinical Oncology, and European Society of Medical Oncology databases. The pooled efficacy and side effects of amifostine in these patients were calculated using the statistics software Stata 11.0. RESULTS: Nine trials that included 769 (381 and 388 in each arm) patients were analyzed. The pooled relative risk of complete, partial, and objective responses were 1.16 (95% CI: 0.90-1.50, Z = 1.07, P = 0.29), 1.02 (95% CI: 0.87-1.19, Z = 0.21, P = 0.83) and 1.06 (95% CI: 0.97-1.17, Z = 1.31, P = 0.20), respectively. The side effects in seven trials including 738 (367 and 371 in each arm) patients were analyzed. The pooled relative risk of developing grades 3 to 4 esophagitis and pneumonitis were 0.51 (95% CI: 0.37-0.72, Z = 3.88, P < 0.001) and 0.51 (95% CI: 0.26-0.99, Z = 1.98, P = 0.04), respectively. CONCLUSIONS: Amifostine can significantly decrease the risk of developing serious esophagitis and pneumonitis without reducing the response rate in NSCLC patients treated by radiotherapy.