Dunst J, Sauer R
Strahlenther Onkol. 1993 Apr;169(4):205-12.
Simultaneous radiochemotherapy (RCT) means the simultaneous application of radiotherapy and chemotherapy. The major objective of this approach is the improvement of local control. On the cellular level, three types of interactions may be distinguished: additivity, synergism, and sensibilization. The main type of interaction seems to be a simple additive effect. The clinical effect of a simultaneous chemotherapy depends mainly on the cytotoxic action of the drug itself and not on radiosensibilization. Therefore, effective chemotherapeutic drugs are to be delivered in cytotoxic dosages in RCT protocols. Compromises in radiotherapy as the main modality should be avoided. Recent clinical data have shown that simultaneous radiochemotherapy may yield high remission rates in a number of tumor entities (e. g. anal cancer, bladder cancer, head and neck cancer). This seems to improve local control as compared to radiotherapy alone. In some tumors (e. g. head and neck, esophagus), survival may be improved also. However, several questions require future detailed clinical trials. These questions include the value of simultaneous radiochemotherapy compared to optimal fractionation schemes, the clear definition of subgroups of patients with benefit by radiochemotherapy and the optimal dose intensity of cytotoxic drugs.
同步放化疗（RCT）是指同时应用放疗和化疗。这种方法的主要目标是提高局部控制率。在细胞水平上，可以区分三种类型的相互作用：相加作用、协同作用和增敏作用。主要的相互作用类型似乎是简单的相加效应。同步化疗的临床效果主要取决于药物本身的细胞毒性作用，而非放射增敏作用。因此，在RCT方案中应以细胞毒性剂量给予有效的化疗药物。应避免以放疗作为主要治疗方式时做出妥协。近期临床数据表明，同步放化疗在多种肿瘤类型（如肛管癌、膀胱癌、头颈癌）中可能产生较高的缓解率。与单纯放疗相比，这似乎能改善局部控制。在某些肿瘤（如头颈癌和食管癌）中，生存率也可能提高。然而，一些问题需要未来进行详细的临床试验。这些问题包括同步放化疗与最佳分割方案相比的价值、明确界定从放化疗中获益的患者亚组以及细胞毒性药物的最佳剂量强度。
