目的：對正常組織的毒性反應作用一直是同步性化學放射治療的主要限制因素。在這次的研究裡，我們評估頭頸部癌症的患者，對於使用amifostine在同步化學放射治療時的保護效果及其毒性。病人與方法：自2000年6月至2002年11月，共有16位頭頸部癌症的患者接受同步性化學放射線治療。患者接受的放射線治療劑量為每日180cGy，範圍從64.8至72.0Gy。化學治療為在放射線治療期間，每週接受cisplatin (CDDP) 30.0 mg/平方公尺。每次放射線治療前15分鐘，給予amifostine (300mg/平方公尺)3分鐘的快速滴注。患者每個星期記錄amifostine的保護效果及其毒性。結果：16位患者中，有8位的患者因為amifostine所導致的副作用而必須暫停使用amifostine。其中5個患者必須將劑量減到210mg/平方公尺，3位停止繼續使用amifostine。Amifostine所導致的副作用造成7位病人放射線治療2到7天的延遲，甚至有一位患者因為嚴重的副作用而必須停止治療。口乾、吞嚥困難及口腔發炎等同步化學放射線治療的副作用，在所有患者均有觀察到。有6位患者產生3級口乾的副作用。嚴重的4級副作用發生在1位患者身上。1年整體存活率為78%，2年整體存活率為60%。結論：對於頭頸部患者，每次放射治療前給予經由靜脈輸注的amifostine 300 mg/平方公尺，伴隨嚴重的副作用。建議調整起始劑量或者改變途徑。

Objective: Toxicity to normal tissues remains a major treatment-limiting factor in concurrent chemoradiation therapy (CCRT). This study was conducted to evaluate the toxicity of amifostine used along with CCRT to treat head and neck cancer. Patients and Methods: The medical records of 16 patients with head and neck cancer treated from June 2001 to November 2003 with CCRT plus amifostine in our department were retrospectively analyzed. The primary tumor was in the nasopharynx in 6, oropharynx in 6, and oral cavity in 4. Radiotherapy (RT) was administered to the primary tumor and regional lymph nodes at a dose of 64.8 to 72Gy over 7 to 8 weeks. Chemotherapy consisted of 6 weekly doses of cisplatin (30 mg/m^2) given approximately 1 hour prior to RT. A rapid 3-minute intravenous infusion of amifostine, 300 mg/m^2, was given 15 minutes before each RT fraction. All patients were examined at the end of each week. Adverse effects of amifostine were recorded. Results: In 8 of the 16 patients (50%), the amifostine therapy had to be discontinued or reduced because of amifostine-related toxicity. The dose was reduced to 210 mg/m^2 in 5 patients and stopped completely in another 3. Amifostine-related adverse effects resulted in delay of RT by 2 to 7 days in 7 of the 16 patients, and RT could not be completed in 1 patient. Long-term amifostine-related toxicity was not observed.