Tepper J E, Shipley W U, Warshaw A L, Nardi G L, Wood W C, Orlow E L
J Clin Oncol. 1987 Apr;5(4):579-84. doi: 10.1200/JCO.1987.5.4.579.
We tested the efficacy of the hypoxic cell sensitizer misonidazole in conjunction with intraoperative electron beam radiation therapy (IORT) and external beam irradiation in patients with locally advanced, nonmetastatic adenocarcinoma of the pancreas. Misonidazole was delivered intravenously (IV) at a dose of 3.5 g/m2 in conjunction with IORT of 1,500 to 2,000 cGy to the pancreas. Additional external beam radiation as administered to 4,960 cGy. The study was based on the premise that the effect of misonidazole would be maximized when a high dose of the drug was administered and, thus, high hypoxic cell sensitization could be obtained when using a high single dose of radiation where the hypoxic fraction would be expected to dominate in the survivors. In a nonrandomized study of 41 patients treated with misonidazole and 22 without, the 1-year local control was 67% and 55%, and 1-year survival was 50% and 77%, respectively. Although there was a bias towards larger tumors in the patients treated with the sensitizer, we were unable to demonstrate an advantage to misonidazole in this clinical situation.
我们测试了低氧细胞增敏剂米索硝唑联合术中电子束放射治疗（IORT）及外照射对局部晚期、非转移性胰腺腺癌患者的疗效。米索硝唑以3.5 g/m²的剂量静脉注射，同时对胰腺进行1500至2000 cGy的IORT。另外给予4960 cGy的外照射。该研究基于这样一个前提，即当给予高剂量药物时，米索硝唑的效果将最大化，因此，当使用高单次剂量放射时，由于预计在存活者中低氧部分占主导，可获得高的低氧细胞增敏效果。在一项对41例接受米索硝唑治疗的患者和22例未接受该治疗的患者的非随机研究中，1年局部控制率分别为67%和55%，1年生存率分别为50%和77%。尽管接受增敏剂治疗的患者中肿瘤较大的比例偏高，但在这种临床情况下，我们未能证明米索硝唑具有优势。
