Famotidine as a radioprotector for rectal mucosa in prostate cancer patients treated with radiotherapy Phase I/II randomized placebo-controlled trial

• Published in: Strahlentherapie und Onkologie Vol. 190; no. 8; pp. 739 - 744
• Main Authors: Razzaghdoust, A., Mozdarani, H., Mofid, B.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-08-2014; Springer Nature B.V
• Subjects: Administration, Oral; Aged; Aged, 80 and over; Dose Fractionation; Dose-Response Relationship, Drug; Drug Administration Schedule; Famotidine - administration & dosage; Gastrointestinal Hemorrhage - prevention & control; Humans; Intestinal Mucosa - radiation effects; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Pilot Projects; Premedication; Prostatic Neoplasms - radiotherapy; Radiation Injuries - prevention & control; Radiation-Protective Agents - administration & dosage; Radiotherapy; Radiotherapy Dosage; Rectum - radiation effects; Rectum; Prostate neoplasms; Prostatakarzinom; Randomized trial; Rektum; Radiotherapy; Akute Toxizität; Acute toxicity; Strahlentherapie
• ISSN: 0179-7158; 1439-099X
• DOI: 10.1007/s00066-014-0602-8

Background and purpose
Acute bowel toxicity significantly affects the quality of life of patients treated with pelvic radiotherapy. This study was performed to assess whether pretreatment with famotidine can reduce acute radiation toxicities in patients undergoing radiotherapy for prostate cancer.
Patients and methods
Between April 2012 and February 2013, 36 patients undergoing radiotherapy for prostate cancer were enrolled to receive either placebo or famotidine. The patients received external-beam radiotherapy up to 70 Gy at daily fractions of 1.8–2 Gy (5 days/week). Oral famotidine 40 mg (80 mg/day) or placebo was administered twice daily (4 and 3 h prior to each radiotherapy fraction). Bowel and bladder acute toxicities were evaluated weekly during radiotherapy and once thereafter according to RTOG grading criteria.
Results
Famotidine was well tolerated. No grade III or higher acute toxicities were noted in the two groups. Grade II rectal toxicity developed significantly more often in patients receiving placebo than in patients receiving famotidine (10/18 vs. 2/16,
p
 = 0.009). Moreover, no rectal bleeding occurred in the famotidine group, while 5 patients in the placebo group experienced rectal bleeding during treatment (
p 
= 0.046). The duration of rectal toxicity in the radiotherapy course was also reduced in the famotidine group (15.7 vs. 25.2 days,
p
 = 0.027). No significant difference between the two groups was observed in terms of urinary toxicity.
Conclusion
We demonstrated for the first time that famotidine significantly reduces radiation-induced injury on rectal mucosa representing a suitable radioprotector for patients treated with radiotherapy for prostate cancer.