Jäckel M, Tausch-Treml R, Köpf-Maier P
Department of Otorhinolaryngology, Klinikum Steglitz, Free University of Berlin, Germany.
Laryngoscope. 1994 Mar;104(3 Pt 1):329-34. doi: 10.1288/00005537-199403000-00015.
The optimum integration of chemotherapy and irradiation is of potential clinical significance in the treatment of advanced head and neck carcinomas. In the present study, the interaction of cis-diamminedichloroplatinum(II) (cisplatin) with fractionated radiotherapy was investigated in a human hypopharynx carcinoma and a cisplatin-resistant subline of this tumor, both growing in athymic mice. Two radiochemotherapy schedules which tested single as well as combined-modality treatments were applied. After therapy, the tumor sizes were measured three times per week in order to determine growth delay and treatment:control (T/C) ratios. The results revealed approximately additive effects of both agents in the parent hypopharynx carcinoma. In the resistant subline, such an interaction did not appear after treatment with any of the investigated schedules. However, a significant cross-resistance between cisplatin and radiation was detectable. It can be concluded that multiple courses of a platinum-based induction chemotherapy may be disadvantageous, since the treated tumors may develop drug resistance which obviously limits the effectiveness of a subsequent combined-modality approach.
化疗与放疗的最佳结合在晚期头颈癌的治疗中具有潜在的临床意义。在本研究中,研究了顺二氯二氨铂(顺铂)与分次放疗在人下咽癌及其顺铂耐药亚系中的相互作用,这两种肿瘤均生长于无胸腺小鼠体内。应用了两种测试单一及联合治疗方式的放化疗方案。治疗后,每周三次测量肿瘤大小,以确定生长延迟和治疗:对照(T/C)比值。结果显示,在亲代下咽癌中,两种药物的作用大致呈相加效应。在耐药亚系中,用任何一种研究方案治疗后均未出现这种相互作用。然而,顺铂与放疗之间可检测到显著的交叉耐药性。可以得出结论,多疗程铂类诱导化疗可能不利,因为经治疗的肿瘤可能产生耐药性,这显然限制了后续联合治疗方法的有效性。