Steel G G
Radiotherapy Research Unit, Institute of Cancer Research, Surrey, U.K.
Radiother Oncol. 1988 Jan;11(1):31-53. doi: 10.1016/0167-8140(88)90044-8.
The literature on combined treatment with radiation and cytotoxic drugs in experimental tumours and normal tissues of laboratory animals is reviewed in the context of the four previously proposed mechanisms whereby a therapeutic advantage might be gained. There is evidence for strong time-dependent processes occurring in some normal tissues. In tumours, the evidence for this is much weaker and there is considerable disparity among experimental tumours in optimum timing. This review leads to the conclusion that the clinical use of drug-radiation combinations should not be based on an anticipated beneficial interaction; gain will most probably come from the best radiotherapy and the best chemotherapy given as far as possible independently. Deleterious interactions can be reduced by allowing a gap of some weeks between chemotherapy and radiotherapy and by avoiding drugs that are known to enhance radiation damage to the normal tissues that are irradiated.
结合放射治疗与细胞毒性药物对实验动物肿瘤及正常组织进行联合治疗的相关文献，在先前提出的四种可能获得治疗优势的机制背景下进行了综述。有证据表明，某些正常组织中存在强烈的时间依赖性过程。而在肿瘤组织中，这方面的证据要弱得多，并且不同实验肿瘤在最佳时间选择上存在很大差异。该综述得出的结论是，药物与放射联合治疗的临床应用不应基于预期的有益相互作用；获益最有可能来自尽可能独立给予的最佳放疗和最佳化疗。通过在化疗和放疗之间留出数周的间隔，并避免使用已知会增强对受照射正常组织辐射损伤的药物，可以减少有害的相互作用。
