***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To evaluate chronic xerostomia and tumor control 18 and 24 months after initial treatment with amifostine in a r and omized controlled trial of patients with head- and -neck cancer ; at 12 months after radiotherapy ( RT ) , amifostine had been shown to reduce xerostomia without changing tumor control . METHODS AND MATERIAL S Adults with head- and -neck cancer who underwent once-daily RT for 5 - 7 weeks ( total dose , 50 - 70 Gy ) received either  open-label amifostine ( 200 mg/m2 i.v . ) 15 - 30 min before each fraction of radiation ( n = 150 ) or RT alone ( control ; n = 153 ) . RESULTS Amifostine administration was associated with a reduced incidence of Grade > or = 2 xerostomia over 2 years of follow-up ( p = 0.002 ) , an increase in the proportion of patients with meaningful ( > 0.1 g ) unstimulated saliva production at 24 months ( p = 0.011 ) , and reduced mouth dryness scores on a patient benefit question naire at 24 months ( p < 0.001 ) . Locoregional control rate , progression-free survival , and overall survival were not significantly different between the amifostine group and the control group . CONCLUSIONS Amifostine administration during head- and -neck RT reduces the severity and duration of xerostomia 2 years after treatment and does not seem to compromise locoregional control rates , progression-free survival , or overall survival Concurrent chemotherapy and radiation has improved the outcome for patients presenting with locally advanced squamous cell carcinomas of the head and neck ( SCCHN ) . These improvements have come at a cost of increased treatment-related toxicities . We previously reported the results of a phase II trial examining the role of concurrent carboplatin , paclitaxel , and daily radiotherapy ( RT ) in SCCHN . In an attempt to decrease these side effects , we conducted a prospect i ve phase II trial evaluating the role of amifostine ( Ethyol , MedImmune Oncology , Inc , Gaithersburg , MD ) in patients treated with this concurrent chemoRT scheme . From April 2002 to September 2004 , 19 patients with stage III-IV SCCHN were enrolled on a prospect i ve phase II trial . Treatment consisted of daily RT delivered to 70.2 Gy ( 1.8 Gy/fx ) with amifostine 500 mg IV ( < 1 hour before RT ) , and concurrent weekly carboplatin ( 100 mg/m2 ) and paclitaxel ( 40 mg/m2 ) . Median age was 58.5 years ( range , 48 to 70 years ) ; male to female ratio was , 83%:17 % ; Caucasian versus other was , 61%/39 % . Tumor characteristics based on histology were : primary cancers of the oropharynx ( 55.6 % ) ; supraglottic larynx ( 16.7 % ) ; hypopharynx ( 16.7 % ) ; oral cavity ( 5.6 % ) ; and unknown primaries ( 5.6 % ) . All patients presented with locally advanced , unresectable disease T4 ( 50 % ) , T3 ( 27.8 % ) , and advanced nodal disease ( N2b-N3 ) ( 78 % ) . Toxicities were measured weekly during treatment and at each follow-up visit . Disease response to therapy was determined 2 months after completion of therapy . Seventeen patients are evaluable for response and survival at 2 months following completion of RT . Eighty-four percent completed the prescribed radiation treatment , and 84 % of patients received more than six cycles of chemotherapy . The median number of missed chemotherapy cycles was 1.5 ( range , 0 to 5 cycles ) . Fifty-six percent of patients received more than 90 % of prescribed amifostine doses , with chemoRT-related toxicity being the most common reason for withholding the dose ( 77 % ) . Median doses of missed amifostine were three ( range , 0 to 30 doses ) . Grade 3 toxicities associated with therapy were : mucositis and dysphagia ( 40 % of patients each ) , dehydration ( 27 % ) , xerostomia ( 20 % ) , and dermatitis ( 20 % ) ; 53 % of patients experienced grade 3 leukopenia , while grade 3/4 neutropenia developed in 20%/13 % . No grade 4/5 nonhematologic toxicities were encountered . Forty percent of patients completed RT without unscheduled treatment breaks secondary to treatment-related toxicity . Median treatment-break time was 5 days ( range , 0 to 20 days ) . Clinical complete response at both the primary site of disease and neck was achieved in 75 % of patients 2 months following completion of RT . Weekly carboplatin and paclitaxel administered concurrently with definitive RT and daily amifostine is well tolerated , with over 85 % of patients completing therapy with acceptable toxicity . The addition of amifostine appears to decrease treatment-related toxicity without impacting efficacy In a r and omized phase II trial in Germany , we investigated the clinical and economic impact of amifostine protection against the hematological and oral toxicities of carboplatin administered concurrently with st and ard fractions of radiotherapy . 28 patients with squamous cell carcinomas of the head and neck received  adjunctive or primary radiotherapy ( 5 days per week with daily fractions of 2 Gy , up to a total dose of 60 Gy ) in conjunction with carboplatin ( 70 mg/m2 ) on days 1–5 and days 21–26 . All patients received radiation encompassing at least 75 % of the major salivary gl and s. Patients were r and omized to receive radiation and carboplatin ( RCT ) alone or RCT preceded by rapid infusion of amifostine ( 500 mg ) on days carboplatin was administered . The 14 patients who received  amifostine , in comparison to 14 patients in the control arm , had significantly fewer episodes of grade 3 or 4 thrombocytopenia ( p = 0.001 ) , mucositis ( p = 0.001 ) , and xerostomia ( p = 0.001 ) . The patients receiving amifostine accrued significantly lower supportive care costs for re sources related to infection ( $ 241 vs. $ 1,275 , p < 0.01 ) , red blood cell and platelet support ( $ 286 vs. $ 1,276 p = 0.06 ) alimentation ( $ 343 vs. $ 894 , p = . 01 ) , and hospitalization ( $ 286 vs. $ 2,429 , p < 0.01 ) . Overall , including the costs of amifostine , mean per patient supportive care costs were $ 4,401 for the amifostine group and $ 5,873 ( p = .02 ) for the control group . Our results from a r and omized phase II trial indicate that selective cytoprotection with amifostine potentially offers clinical and economic benefits in patients with advanced head and neck cancer receiving radiochemotherapy . Additional economic studies alongside r and omized phase III trials and from other countries are needed This phase II trial was design ed to verify that subcutaneous ( SC ) administration of Amifostine ( Ethyol ) protects against radiation  therapy (RT)-induced  xerostomia and ameliorates  amifostine-related side effects ( including nausea , vomiting , and hypotension ) .  Patients receiving amifostine SC plus RT had a 56 % incidence of acute xerostomia  , comparable with previous phase III data with intravenous administration of amifostine . There was good tolerability , with cutaneous toxicity as the most significant side effect . These data suggest that amifostine SC provided comparable protection against RT-induced acute xerostomia as amifostine intravenously A prospect i ve r and omized study is comparing intravenous ( IV ; arm A ) versus subcutaneous ( SC ; arm B ) administration of amifostine in patients receiving radiotherapy for head and neck cancer . Main eligibility criteria were newly diagnosed squamous cell head and neck cancer , inclusion of at least 75 % of both parotid gl and s within radiation fields that would receive at least 40 Gy , and no evidence of distant metastasis . Prophylactic use of pilocarpine and concomitant chemotherapy were prohibited . Intravenous administration of amifostine is 200 mg/m2/d in a short 3-minute infusion 15 to 30 minutes before each fraction of radiotherapy . Subcutaneous administration is 500 mg/d in two , slow 1.25-mL injections at two different sites 20 to 60 minutes before each radiotherapy fraction .  Antiemetic treatment  and blood pressure monitoring are required in both arms . As of April 25 , 2002 , 111 of the 292 required patients were included . Data are available for the first 54 patients .  Acute toxicity included nausea/vomiting ( 12 % for arm A ; 13 % for arm B ) , hypotension ( 6 % in arm A ; 0 % in arm B ) , skin rash ( 15 % in arm A ; 16 % in arm B ) , and asthenia ( 4 % in arm A ; 0 % in arm B ) . Compliance with amifostine administration was 70 % in arm A ( IV ) and 80 % in arm B ( SC ) . The rate of acute xerostomia ( > or = grade 2 ) was 23 % in arm A and 19 % in arm B. These preliminary results indicate that tolerance is better with SC than IV administration , particularly because of the absence of hypotension . The absence of hypotension with SC administration facilitates patient monitoring and management in radiotherapy departments . More patients and data are required to assess the long-term efficacy of SC administration on acute and late xerostomia Amifostine was developed to protect normal tissues from radiation exposure . The current study was undertaken to determine whether amifostine would allow the delivery of greater numbers of weekly paclitaxel treatments with concomitant , hyperfractionated radiotherapy in patients with advanced head and neck carcinoma PURPOSE To determine the prophylactic properties of amifostine against acute and late toxicities from radiochemotherapy in patients with head- and -neck cancer . METHODS AND MATERIAL S Fifty patients were r and omized to receive conventional radiotherapy ( RT ) ( 2-Gy fractions , 5 days weekly , to a total of 60 - 74 Gy , depending on the tumor localization and TNM classification ) and carboplatin ( 90 mg/m(2 ) infusion once per week before RT ) . Amifostine ( 300 mg/m(2 ) ) was administered in the study group only 15 - 30 min before RT for 6 - 7.5 weeks . The primary study end point was the grading of acute and late nonhematologic toxicities ( mucositis , dysphagia , xerostomia ) induced by radiochemotherapy . Secondary end points included treatment duration , hematologic toxicity , and clinical outcome . RESULTS The treatment duration was significantly shorter in the amifostine-treated group ( p = 0.013 ) , because treatment interruptions were more frequent in the control group . Acute toxicities ( mucositis and dysphagia ) were less severe in the amifostine-treated group . By Week 3 , all in the control group experienced Grade 2 mucositis compared with only 9 % in the amifostine-treated group ( p < 0.0001 ) . By Week 5 , 52.2 % of the patients in the control group experienced Grade 4 mucositis compared with 4.5 % in the amifostine-treated group ( p = 0.0006 ) . Similar results were obtained for dysphagia . At 3 months of follow-up , only 27 % of patients in the study group experienced Grade 2 xerostomia compared with 73.9 % in the control group ( p = 0.0001 ) . Eighteen months after cessation of therapy , the proportion of patients with Grade 2 xerostomia was 4.5 % vs. 30.4 % for each respective treatment group ( p = 0.047 ) . Cytoprotection with amifostine did not affect treatment outcome , with 90.9 % complete responses in the amifostine-treated group compared with 78.3 % in the control group ( p = 0.414 ) . CONCLUSION Amifostine was effective in reducing mucositis and dysphagia result ing from radiochemotherapy in patients with head- and -neck cancer . Furthermore , amifostine reduced the severity of late xerostomia , a side effect of RT with long-lasting consequences . Amifostine treatment did not affect the clinical outcome PURPOSE To determine if head and neck ( H/N ) cancer patients receiving daily amifostine during radiation therapy ( RT ) experienced clinical benefit ( improvement in their ability to carry out normal functions with reduced discomfort ) compared to nonamifostine treated patients . METHODS AND MATERIAL S This was an open-label , multi-institutional r and omized trial in 303 H/N cancer patients treated with RT + amifostine .  Clinical benefit was measured using an 8-item vali date d Patient Benefit Question naire ( PBQ ) during and up to 11 months after RT . RESULTS 30 
    Output:
    
This systematic review showed that amifostine significantly reduce the serious mucositis , acute/late xerastomia and dysphagia without protection of the tumor in HNSCC patients treated with radiotherapy .
And the toxicities of amifostine were generally acceptable