Rotman M, Aziz H, Choi K, Schwartz D, Aral I, Schulsinger A, Cirrone J, Torres C, Desai A
Department of Radiation Oncology, State University of New York Health Sciences Center, Brooklyn 11203, USA.
Rays. 1997 Jul-Sep;22(3):372-92.
Chemotherapeutic agents, used alone or in combination, have had a largely palliative effect in the treatment of solid tumors. The curative ability of these agents has been limited to about 15% of cases, in large measure due to chemotherapy's failure to accomplish locoregional control, leaving surgery or irradiation for local control of primary disease as modes of treatment. In many cases, however, surgery is not a feasible alternative, and radiation therapy may fail because of radioresistance. Whether this is caused by anoxia or by the innate radioresistance of the tumor cell, radiation oncologists have tried a number of methods to overcome the resulting insensitivity. Experience with the continuous concomitant infusion of various cytotoxic agents and radiation therapy in the treatment of advanced malignancies has been encouraging. The resultant radiosensitization has let to an increased rate of locoregional clearance of advanced carcinomas with a worthwhile increase in survival rates. The use of infusion chemo- and radiation therapy also has allowed the use of an organ-sparing program in all but the most advanced stages. There are already encouraging reports on successful organ-sparing treatment programs for carcinoma of the anus, esophagus and bladder. (ABSTRACT TRUNCATED)
单独或联合使用的化疗药物在实体瘤治疗中大多只有姑息作用。这些药物的治愈能力仅限于约15%的病例，很大程度上是因为化疗未能实现局部区域控制，从而将手术或放疗作为原发性疾病局部控制的治疗方式。然而，在许多情况下，手术并非可行的选择，而放射治疗可能因肿瘤细胞的放射抗性而失败。无论这是由缺氧还是肿瘤细胞固有的放射抗性引起的，放射肿瘤学家都尝试了多种方法来克服由此产生的不敏感性。在晚期恶性肿瘤治疗中持续同步输注各种细胞毒性药物和放射治疗的经验令人鼓舞。由此产生的放射增敏作用提高了晚期癌的局部区域清除率，并使生存率有了可观的提高。输注化疗和放射治疗的应用还使得除最晚期阶段外，均可采用器官保留方案。已有关于肛门癌、食管癌和膀胱癌成功的器官保留治疗方案的令人鼓舞的报道。（摘要截断）
