Abstract

Objective: The supportive strategy of cytoprotection is based on the idea of scavanging free radicals in order to decrease side effects due to anticancer treatment. We have investigated amifostine and sodium selenite regarding its scavanging potential in head and neck cancer patients during radiochemotherapy. Material and methods: One hundred cancer patients received simultaneous radiochemotherapy. During irradiation, 31 patients (Group 1) got 500 µg sodium selenite per day, 29 patients (Group 2) got 500 mg amifostine, and 40 patients (Group 3) got 500 mg sodium selenite and 500 mg amifostine. Amifostine was given at days with chemotherapy only. We measured serum selenium concentration, activity of glutathione peroxidase and concentration of malondialdehyde at the beginning of radiotherapy, after three weeks and at the end of combined treatment. Results: We have seen differences in the serum selenium level of the patients regarding their tumor volume. Sodium selenite, in the amount of 500 mg, was able to correct decreased selenium concentrations within three weeks. The activity of glutathionperoxidase was increased when selenium was substituted. A reduction of malondialdehyde, e.g. aggressive free radicals, were seen in patients with selenium substitution and smaller tumors (Group 1) only. If the tumor volume was larger and the therapy more aggressive, the therapy-induced production of new free radicals was limited (Groups 2 and 3). The combination of sodium selenite and amifostine (Group 3) was more effective than the administration of amifostine alone (Group 2). Conclusion: The substitution of sodium selenite is able to reduce the endogenous level of aggressive free radicals in head and neck cancer patients. Further clinical studies are necessary to evaluate synergisms with other exogenous scavangers of free radicals (for example amifostine) and to evaluate the toxicity-limiting possibilities of this new supportive strategy.

Author Details

Authors

• J. Büntzel¹,³
• O. Micke³
• R. Mücke³
• M. Glatzel²,³
• K.G. Schönekaes³
• U. Schäfer³
• K. Kisters³
• F. Bruns³

Departments

• ¹ Department of Otolaryngology, Südharz Hospital, Nordhausen,
• ² Department of Radiotherapy, Central Hospital, Suhl, Germany, and
• ³ The German Working Group “Trace Elements and Electrolytes in Radiation Oncology” (AKTE)

Address

Dr. J. Büntzel
Klinik für HNO-Erkrankungen, Kopf-Hals-Chirurgie
Südharzkrankenhaus Nordhausen gGmbH
Dr.-Robert-Koch-Straße 39
99734 Nordhausen, Germany
Email: [email protected]

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