Microsoft word - 48-54ahmadlo.doc

Effect of Oral Sucralfate on Side Effects of External Radiation Therapy in
Patients with Head and Neck Cancer

Background: Early side effects of irradiation for head and neck cancers are very common and
disturbing. These events may cause a transient disruption in the treatment course. The aim of
this study was to evaluate the role of sucralfate on radiation side effects. Patients and
Between November 1999 and January 2002, eighty patients with head and neck
cancers who were referred to the Radiotherapy Department of Nemazee Hospital were divided into two groups. Group I was treated with external radiotherapy alone and group II received irradiation and oral sucralfate. The total dose of radiation was at least 50 Gy and sucralfate was started at the beginning of irradiation and was continued for 9 weeks at an oral dose of 1 gram, three times a day. The patients were evaluated weekly and the side effects were scored. Results: The intensity of radiation
side effects (subjective tolerance, dysphagia, dermatitis and mucositis and also treatment time interruption) did not differ significantly between the two groups (p>0.05). However, Shiraz University of Medical Sciences, sucralfate significantly induced more nausea and vomiting in Group II as compared to Group I (p<0.05). Conclusion:
According to this study, using sucralfate in order to decrease radiation-induced side effects in head and neck cancers not only is ineffective in reducing radiation mucositis and other side effects but also induces nausea and vomiting. Correspondence:
Keywords: Cancer, Head and neck, Radiotherapy, Sucralfate,
N. Ahmadloo
[1]Lievens Y, Haustermans K, Van den Weyngaert D, et al.: Does Tel:+98-711-6260135
sucralfate reduce the acute side-effects in head and neck cancer E-mail:
treated with radiotherapy? A double blind randomized trial. Radiother Oncol 1998; 47:147-53.
[2]Fowler JF, Lindstrom MJ: Loss of local control with prolongation in radiotherapy. Int J Radiat Oncol Biol Phys 1992;
[3]Harari PM, Fowler JF: Idealized versus realized overall
treatment times. Int J Radiat Oncol Biol Phys 1994;29:209-11.
[4]Kaanders JH, Van Daal WA, Hoogenvaad WJ, et al.: Accelerated fractionation radiotherapy
for laryngeal cancer: Acute and late toxicity. Int J Radiat Oncol Biol Phys 1992;24:497-503.
[5]Bruntoon LL: Agents for control of gastric acidity and treatment of peptic ulcers. In :
Hardman JG, Limbird LE, Molinoff PB , eds. Goodman and Gilman’s the pharmacological
basis of therapeutics.
9 th ed. New York, USA: The Mc Graw-Hill Co, 1996:913.
[6]Szabo S, Vattay P, Scarbrought E, et al.: Role of vascular factors including angiogenesis in
the mechanism of action of sucraltate. Am J Med 1991;91:158-60.
[7]Brooks WS: Sucralfate: Non-ulcer uses. Am J Gastroenterol 1995; 80: 206-9.
[8]McCarthy DM: Sucraltate. N Engl J Med 1991; 325:1017-25.
[9]Szabo S, Hollander D: Pathways of gastrointestinal protection and repair: Mechanism of
action of sucralfate. Am J Med 1989; 86: 23-31.
[10]Burch RM, McMillan BA: Sucralfate induces proliferation of dermal fibroblasts and
keratinocytes in culture and granulation tissue formation in full thickness skin wounds. Agents
1991;34: 229-31.
[11]Tarnawski A, Hollander D, Krause WJ, et al.: Does Sucralfate affect the normal gastric
mucosa? Histologic, ultrastructural and functional assessment in the rat. Gastroenterology
[12]Epstein JB, Wong FLW: The efficacy of sucralfate suspension in the prevention of oral
mucositis due to radiation therapy. Int J Radiat Oncol Biol Phys 1994;28: 693-8.
[13]Franzen L,Henriksson R, Littbrand B, et al.: Efffects of sucralfate on mucositis during and
following radiotherapy of malignancies in the head and neck region : A double blind placebo
controlled study. Acta Oncol 1995;34:219-23.
[14]McGinnis WL, Loprinzi CL, Buskirk SJ, et al.: Phase III evaluation of sucralfate for
radiation induced esophagitis. Int J Radiat Oncol Biol Phys 1996; 36 (suppl. 1044):266.
[15]Etiz D, Erkal HS, Serin M, et al.: Clinical and histopathological evaluation of sucralfate in
prevention of oral mucositis induced by radiation therapy in patients with head and neck
malignancies. Oral Oncology 2000; 36:116-20.
[16]Scherlacher A, Beaufort- Spontin F: Radiotherapy of head and neck neoplasms:Prevention
of inflammation of the mucosa by sucralfate treatment. HNO 1990; 38:24-8.


Microsoft word - cdc antiviral messaging 06152009.doc

Antiviral guidance for suspected, probable, or confirmed novel H1N1 influenza The Centers for Disease Control and Prevention would like to emphasize that it is very important to get the word out to clinicians, particularly those in primary care (including internists, pediatricians, family practitioners, OB-GYN physicians) and hospital-based clinicians (emergency physicians, hospitalists, int

Microsoft word - copy of ismpcsb2009-1 - alert revatio _sildenafil_ medication incident.doc

The Institute for Safe Medication Practices Canada (ISMP Canada) is an analysis of medication error reports and ISMP Canada Safety Bulletin ALERT: Revatio (sildenafil) Medication Incident It is well-known to healthcare practitioners that use of nitroglycerin therapy is contraindicated in patients taking The urgency of the situation (i.e., patient with sildenafil (commonly known as

Copyright © 2010-2019 Pdf Physician Treatment