Amifostine for children with medulloblastoma treated with cisplatin-based chemotherapy

In adult patients, amifostine appears to ameliorate cisplatin-related nephrotoxicity and ototoxicity. We assessed the safety and efficacy of amifostine in 11 children with newly diagnosed medulloblastoma/primitive neuroectodermal tumor treated with radiotherapy and vincristine, lomustine, and cisplatin. Amifostine was administered immediately prior to and 4 hr into the cisplatin infusion. Amifostine caused assymptomatic hypotension and hypocalcemia in 18 and 82% of patients, respectively. Despite amifostine use, 78% of patients developed significant ototoxicity. Although relatively well tolerated, amifostine does not appear to have a major impact on ameliorating the risk of developing significant nephro- and ototoxicity in children with medulloblastoma. Larger studies will help clarify these findings.