American Society of Clinical Oncology 2008 Clinical Practice Guideline Update Summary: Use of Chemotherapy and Radiation Therapy Protectants

ASCO recently convened an update committee of the expert panel on the use of chemotherapy and radiation therapy protectants to review ASCO's Clinical Practice Guideline on this topic.In 2002, ASCO updated the original 1999 guideline.This 2008 updated guideline addresses the role of currently available chemotherapy and radiation therapy protectants in decreasing the incidence and/or the severity of toxicities associated with the use of chemotherapy and radiation therapy to treat cancer.The updated guideline includes a new section on the use of palifermin to prevent mucositis associated with stem cell transplantation, and discusses the use of amifostine for the prevention of radiation-associated esophagitis.The US Food and Drug Administration (FDA) approved palifermin, a recombinant keratinocyte growth factor, for prophylaxis against severe mucositis associated with hematopoietic stemcell transplant (HSCT) in hematologic malignancies.For several recommendations, there was no new evidence and those recommendations remain unchanged.Due to the large number of recommendations in this guideline, this summary describes only those which changed.A complete list of recommendations is available online www.asco.org/guidelines/protectant. Changes Since 2002 Guideline Dexrazoxane Use of Dexrazoxane for Patients Receiving High-Dose Anthracycline TherapyBecause there were no new data on the use of dexrazoxane or on the clinical use of high-dose anthracyclines, the panel felt a recommendation on this topic had limited clinical relevance and deleted its previous recommendation. AmifostineAmifostine Use in Chemotherapy-Associated Toxicities: Neutropenia Amifostine Use in Radiation Therapy-Associated Toxicities: Mucositis This recommendation was changed slightly