Rhomberg Walter, Eiter Helmut, Böhler Franz, Dertinger Susanne
Federal Academic Hospital, Department of Radiooncology, A-6800 Feldkirch, Austria.
Anticancer Res. 2006 May-Jun;26(3B):2407-11.
Chondrosarcomas and chordomas are reported to have low radio-sensitivity. Therefore, a study was undertaken to explore the radioresponsiveness of these tumours using the sensitising agent razoxane.
Thirteen chondrosarcomas and five chordomas were irradiated with high-energy photons and razoxane in the period from 1984 to 2003. The median tumour dose was 60 Gy in the chondrosarcomas and 63 Gy in chordomas. Razoxane tablets were given at a dose of 125 mg twice daily starting 5 days before the first irradiation. The drug was continued on radiation days.
Eight out of the 13 chondrosarcomas had unresectable or recurrent measurable disease. There were one complete and five partial responses, while two tumours remained unchanged (response rate 75%). The median duration of response was 22 months. Three out of four patients without clear surgical margins and one patient with clear margins had locally controlled disease. Overall, local control was achieved in seven out of twelve patients who were not radically resected. All five patients with chordomas survived 5 years and remained locally controlled at that time. Among four measurable tumours, two complete and one partial regression were noted. Razoxane was well tolerated; the dose limiting toxicity was leukopenia.
Photon irradiation together with razoxane induces major responses in a majority of patients with chondrosarcomas and chordomas. This combination therapy seems to be more effective than photon irradiation alone.
据报道，软骨肉瘤和脊索瘤的放射敏感性较低。因此，开展了一项研究，使用增敏剂丙亚胺来探索这些肿瘤的放射反应性。
1984年至2003年期间，对13例软骨肉瘤和5例脊索瘤进行了高能光子和丙亚胺照射。软骨肉瘤的中位肿瘤剂量为60 Gy，脊索瘤为63 Gy。丙亚胺片剂量为125 mg，每天两次，在首次照射前5天开始服用。放疗期间持续用药。
13例软骨肉瘤中有8例存在不可切除或复发性可测量病灶。有1例完全缓解和5例部分缓解，2例肿瘤无变化（缓解率75%）。缓解的中位持续时间为22个月。4例手术切缘不清晰的患者中有3例以及1例切缘清晰的患者实现了局部疾病控制。总体而言，12例未接受根治性切除的患者中有7例实现了局部控制。所有5例脊索瘤患者均存活5年，且当时仍处于局部控制状态。在4例可测量肿瘤中，观察到2例完全消退和1例部分消退。丙亚胺耐受性良好；剂量限制性毒性为白细胞减少。
光子照射联合丙亚胺可使大多数软骨肉瘤和脊索瘤患者产生主要反应。这种联合治疗似乎比单纯光子照射更有效。
