Rotman M Z
Department of Radiation Oncology, State University of New York, NY 11203.
Radiology. 1992 Aug;184(2):319-27. doi: 10.1148/radiology.184.2.1620823.
The use of concomitant continuous infusion chemotherapy and radiation therapy in the treatment of a variety of tumors has produced, in relatively limited clinical experience, substantial improvements in complete response and survival rates. Although there is still a need to establish the most effective combinations, concentrations, and scheduling of drugs, as well as optimum dose and fractionation of radiation, a number of benefits have already been recorded with this approach. Organ preservation is maximized in all but the most advanced cancers of the anus, esophagus, and bladder. In advanced head and neck cancers, particularly in the paranasal sinuses when bone destruction and infiltration have occurred, the total dose required for effective therapy can be reduced by 15%-30%, which substantially lowers the rate of complications. Therapeutic gains have also been seen in the treatment of other primary and recurrent gastrointestinal and gynecologic malignancies and their hepatic metastases. Finally, there is considerable potential for this approach in the treatment of bulky or recurrent soft-tissue sarcomas, particularly in the extremities.
在多种肿瘤的治疗中，同时使用持续静脉输注化疗和放射治疗，尽管临床经验相对有限，但已使完全缓解率和生存率有了显著提高。尽管仍需确定最有效的药物组合、浓度和给药方案，以及放射治疗的最佳剂量和分割方式，但这种方法已显示出诸多益处。除了肛门、食管和膀胱的最晚期癌症外，其他癌症通过这种方法能最大程度地保留器官。在晚期头颈癌中，尤其是发生骨破坏和浸润的鼻窦癌，有效治疗所需的总剂量可降低15% - 30%，这大大降低了并发症发生率。在治疗其他原发性和复发性胃肠道及妇科恶性肿瘤及其肝转移瘤方面也取得了治疗效果。最后，这种方法在治疗体积较大或复发性软组织肉瘤，尤其是四肢的此类肉瘤方面具有很大潜力。
