Phillips T L, Fu K K
Cancer. 1977 Jul;40(1 Suppl):489-94. doi: 10.1002/1097-0142(197707)40:1+<489::aid-cncr2820400714>3.0.co;2-c.
The increasing use of combined radiation, chemotherapy, and surgery had led to an increased incidence of acute and late complications. The complications are, in general, similar to those seen with each modality alone, but occur with increased incidence. Enhanced effects of combined radiation and surgery are modest in number and consist primarily of problems with wound healing and fibrosis, as well as late gastrointestinal damage. Combinations of radiotherapy and chemotherapy have shown a greater degree of enhanced acute and late reactions. Drugs, such as actinomycin-D and Adriamycin, are particularly dangerous if the marked enhancement of radiation effects caused by the drugs in almost all organs is not appreciated and the radiation dose not adjusted accordingly. Proper selection of drugs can lead to enhanced local control by radiotherapy and/or surgery, as well as eradication of microscopic distant metastases, without increased normal tissue injury. Late induction of malignancy can occur with either radiation or chemotherapy alone and, in some cases, this appears to be enhanced when they are combined.
联合放疗、化疗和手术的使用日益增加，导致急性和晚期并发症的发生率上升。总体而言，这些并发症与单独使用每种治疗方式时所见的并发症相似，但发生率更高。联合放疗和手术的增强效应数量不多，主要包括伤口愈合和纤维化问题以及晚期胃肠道损伤。放疗和化疗的联合已显示出更大程度的急性和晚期反应增强。如果没有认识到放线菌素-D和阿霉素等药物几乎在所有器官中引起的辐射效应显著增强，且未相应调整辐射剂量，这些药物会特别危险。正确选择药物可通过放疗和/或手术提高局部控制率，并根除微小的远处转移灶，而不会增加正常组织损伤。单独使用放疗或化疗都可能发生晚期恶性肿瘤诱导，在某些情况下，联合使用时这种情况似乎会加剧。
