McGinn C J, Lawrence T S
Department of Radiation Oncology, University of Michigan, Ann Arbor, 48109-0010, USA.
Semin Radiat Oncol. 2001 Oct;11(4):270-80. doi: 10.1053/srao.2001.26002.
Chemotherapeutic drugs that perturb nucleotide metabolism have the potential to produce substantial sensitization of tumor cells to radiation treatment. The clinical effectiveness of fluoropyrimidines as radiosensitizers has been proven in multiple randomized trials. The development of oral fluoropyrimidine formulations may allow protracted exposure without the need for indwelling intravenous lines and infusion pumps. These agents may also provide more selective radiosensitization and are likely to be widely incorporated into chemoradiotherapy regimens for patients with gastrointestinal malignancies. Gemcitabine has been well studied in the laboratory, with respect to mechanisms of radiosensitization and strategies that may increase the therapeutic index. Clinical trials based on these studies are now defining the role of this radiosensitizing nucleoside. Issues regarding the use oral fluoropyrimidines and gemcitabine need to be viewed in the context of both local and distant disease control, given the potential systemic activity of these agents.
干扰核苷酸代谢的化疗药物有可能使肿瘤细胞对放射治疗产生显著的敏化作用。氟嘧啶作为放射增敏剂的临床有效性已在多项随机试验中得到证实。口服氟嘧啶制剂的研发可能使药物能够长时间作用，而无需留置静脉导管和输液泵。这些药物还可能提供更具选择性的放射增敏作用，并可能广泛纳入胃肠道恶性肿瘤患者的放化疗方案中。吉西他滨在实验室中已就放射增敏机制以及可能提高治疗指数的策略进行了充分研究。基于这些研究的临床试验正在明确这种放射增敏核苷的作用。鉴于这些药物潜在的全身活性，在局部和远处疾病控制的背景下看待口服氟嘧啶和吉西他滨的使用问题十分必要。
