Merlano Marco
Department of Clinical Oncology, S. Croce General Hospital, Via M. Coppino 26, 12100 Cuneo, Italy.
Oncologist. 2006 Feb;11(2):146-51. doi: 10.1634/theoncologist.11-2-146.
Rapidly alternating chemotherapy and radiotherapy (ACR) is a minor variation of concurrent chemoradiation (CCR). This scheduling has been tested in advanced head and neck cancer and has shown superiority over standard radiation in some randomized trials with only marginally greater toxicity. This paper reviews ACR in advanced head and neck cancer. The hypothesis that this approach could have a better toxicity profile than CCR is discussed in light of the published clinical data. Efficacy is also discussed on the basis of available phase III trials. Published data indicate that rapidly alternating chemoradiation adds to toxicity less than CCR and results in comparable 3-year overall survival rates. In conclusion, ACR could be as active as, and possibly less toxic than, CCR. Comparative trials are highly recommended.
快速交替化疗和放疗（ACR）是同步放化疗（CCR）的一种微小变体。这种方案已在晚期头颈癌中进行了测试，并且在一些随机试验中显示出优于标准放疗，且毒性仅略高。本文综述了晚期头颈癌中的ACR。根据已发表的临床数据，讨论了这种方法可能比CCR具有更好毒性特征的假设。还根据现有的III期试验讨论了疗效。已发表的数据表明，快速交替放化疗比CCR增加的毒性更小，并且3年总生存率相当。总之，ACR可能与CCR一样有效，并且毒性可能更低。强烈建议进行对比试验。
