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Chemical modifiers of radiation and chemotherapy: tumor sensitization and normal tissue protection

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Head and Neck Oncology

Part of the book series: Cancer Treatment and Research ((CTAR,volume 22))

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Abstract

The need for effective radiosensitizers and protectors is well illustrated by the problem of treating tumors of the head and neck region. Although local control of early stage (T1, T2) tumors is excellent for all sites, control of larger (T3, T4) tumors, with the exception of the nasopharynx, is extremely poor and never above 50–60% [1–4]. Local control can be improved by the combination of radiotherapy with radical surgery however such treatment is extremely morbid and far from 100% effective. The use of an effective radiosensitizer or protector would be expected to improve local control probability without an increase in treatment morbidity.

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References

  1. Fletcher GH, Lindberg RD, Caderao JB, Wharton JT: Hyperbaric oxygen as a radiotherapeutic adjuvant in advanced cancer of the uterine cervix. Preliminary results of a randomized trial. Cancer 39: 617–623, 1977.

    Article  PubMed  CAS  Google Scholar 

  2. Fazekas JT, Sommer C, Kramer S: Adjuvant intravenous methotrexate or definitive radiotherapy alone for advanced squamous cancers of the oral cavity, oropharynx, supraglottic larynx or hypopharynx. Concluding report of an RTOG randomized trial on 638 patient. Int J Radiation Oncology Biol Phys 6: 533–541, 1980.

    Article  CAS  Google Scholar 

  3. Fletcher GH: Place of irradiation in the management of head and neck cancers. Semin Oncol 4: 375–385, 1977.

    PubMed  CAS  Google Scholar 

  4. Hoppe RT, Goffinet DR, Bagshaw MA: Carcinoma of the nasopharynx. Eighteen years experience with megavoltage radiation therapy. Cancer 37: 2605–2612, 1976.

    Article  PubMed  CAS  Google Scholar 

  5. Rubin P, Cooper RA Jr (eds): Radiation Biology and Radiation Pathology Syllabus. Chicago, American College of Radiology, 1975, pp 207–216.

    Google Scholar 

  6. Fletcher GH: The third annual lectureship of the Juan A. Del Regato Foundation. Squamous cell carcinomas of the oropharynx. Int J Radiation Oncology Biol Phys 5: 2075–2090, 1979.

    Article  CAS  Google Scholar 

  7. Perez CA, Lee FA, Ackerman LV, Korba A, Purdy J, Powers WE: Carcinoma of the tonsillar fossa, significance of dose of irradiation and volume treated in the control of the primary tumor and matastatic neck nodes. Int J Radiation Oncology Biol Phys 1: 817–827, 1976.

    Article  CAS  Google Scholar 

  8. Weichselbaum RR, Schmit A, Little JB: Cellular repair factors influencing radiocurability of human malignant tumours. Br J Cancer 45: 10–16, 1982.

    Article  PubMed  CAS  Google Scholar 

  9. Hall EJ: Radiobiology for the radiologist. 2nd edn. New York: Harper & Row, 1978, pp 3–12, 79–92.

    Google Scholar 

  10. Whithers HR, Peters LJ: In: Fletcher GH (ed) Textbook of Radiotherapy. Philadelphia: Lea & Febiger 1980, pp 103–148.

    Google Scholar 

  11. Denekamp J, Hirst DG, Stewart FA, Terry NHA: Is tumour radiosensitization by misonidazole a general phenomenon? Br J Cancer 41: 1–9, 1980.

    Article  PubMed  CAS  Google Scholar 

  12. Ritter MA, Brown DQ, Glover DJ, Yuhas JM: in vitrostudies on the absorption of WR-2721 by tumors and normal tissues. Int J Radiation Oncology Biol Phys 8: 523–526, 1982.

    Article  CAS  Google Scholar 

  13. Yuhas JM: On the potential application of radioprotective drugs in solid tumor radiotherapy. In: Sokol GH, Maickel RP (ed) Radiation-Drug Interactions in the Treatment of Cancer. New York: John Wiley & Sons, 1980, pp 113–135.

    Google Scholar 

  14. Yuhas JM, Spellman JM, Culo F: The role of WR-2721 in radiotherapy and/or chemotherapy. Cancer Clin Trials 3: 211–216, 1980.

    PubMed  CAS  Google Scholar 

  15. Henk JM: Does hyperbaric oxygen have a future in radiation therapy? Int J Radiation Oncology Biol Phys 7: 1125–1128, 1981.

    Article  CAS  Google Scholar 

  16. Henk JM, Kunkler PB, Smith CW: Radiotherapy and hyperbaric oxygen in head and neck cancer. Final report of first controlled clinical trial. Lancet 16: 101–103, 1977.

    Article  Google Scholar 

  17. Henk JM, Smith CW: Radiotherapy and hyperbaric oxygen in head and neck cancer. Interim report of second clinical trial. Lancet 16: 104–105, 1977.

    Article  Google Scholar 

  18. Sause WT, Plenk HP: Radiation therapy of head and neck tumors: A randomized study of treatment in air vs. treatment in hyperbaric oxygen. Int J Radiation Oncology Biol Phys 5: 1833–1836, 1979.

    CAS  Google Scholar 

  19. Urtasun RC, Chapman JD, Band P, Rabin HR, Fryer CG, Sturmwind J: Phase I study of high-dose metronidazole: A specific inin vivoand in vitroradiosensitizer of hypoxic cells. Radiology 117: 129–133, 1975.

    PubMed  CAS  Google Scholar 

  20. Frytak S, Moertel CG, Childs DS, Albers JW: Neurologic toxicity associated with high-dose metronidazole therapy. Ann Int Med 88: 361–362, 1978.

    PubMed  CAS  Google Scholar 

  21. Urtasun R, Band P, Chapman JD, Feldstein ML, Mielke B, Fryer C: Radiation and high- dose metronidazole in supratentorial glioblastomas. N Engl J Med 294: 1364–1367, 1976.

    Article  PubMed  CAS  Google Scholar 

  22. Adams GE, Clarke ED, Flockhart IR, Jacobs RS, Sehmi DS, Stratford IJ, Wardman P, Watts ME: Structure-activity relationships in the development of hypoxic cell radiosensitizers. I. Sensitization efficiency. Int J Radiation Oncology Biol Phys 35: 133–150, 1979.

    CAS  Google Scholar 

  23. Wasserman TH, Phillips TL, Johnson RJ, Gover CJ, Lawrence GA, Sadee W, Marques RA, Levin V, VanRaalte G: Initial clinical and pharmacologic evaluation of Misonidazole (ro- 07–0582) an hypoxic cell radiosensitizer. Int J Radiation Oncology Biol Phys 5: 775–786, 1979.

    CAS  Google Scholar 

  24. Dische S, Saunders MI, Flockhert IR, et al.: Misonidazole –A drug for trial in radiotherapy and oncology. Int J Radiation Oncology Biol Phys 5: 851–860, 1979.

    CAS  Google Scholar 

  25. Phillips TL, Wasserman TH, Johnson RJ, Levin VA, VanRaalte G: Final report on the United States phase I clinical trial of the hypoxic cell radiosensitizer, Misonidazole (Ro-07–0582; NSC #261037). Cancer 48: 1697–1704, 1981.

    Article  PubMed  CAS  Google Scholar 

  26. Thomas GM, Rauth AM, Black RE, Cummings BJ, Norenti VL, Bush RS: A phase I study of misonidazole and pelvic irradiation in patients with carcinoma of cervix. Br J Cancer 45: 860–868, 1982.

    Article  PubMed  CAS  Google Scholar 

  27. Schwade JG, Strong JM, Gangji D: I.V. Misonidazole (NSC 261037). Report of initial clinical experience. In: Brady LW (ed) Radiation Sensitizers: Their use in the Clinical Management of Cancer. New York: Masson Publishing, 1980, pp 414–420.

    Google Scholar 

  28. Dische S: Hypoxic cell sensitisers in radiotherapy. Int J Radiation Oncology Biol Phys 4: 157–160, 1978.

    CAS  Google Scholar 

  29. Ash DV, Smith MR, Bugden RD: Distribution of misonidazole in human tumours and normal tissues. Br J Cancer 39: 503–509, 1979.

    Article  PubMed  CAS  Google Scholar 

  30. Gangji D, Schwade JG, Strong JM: Phenytoin-Misonidazole: Possible metabolic interaction. Cancer Treat Rep 64: 155–156, 1980.

    PubMed  CAS  Google Scholar 

  31. Walker MD, Strike TA: Misonidazole peripheral neuropathy. Its relationship to plasma concentration and other drugs. Cancer Clin Trials 3: 105–109, 1980.

    PubMed  CAS  Google Scholar 

  32. Fazekas JT, Goodman RL, McLean CJ: The value of adjuvant misonidazole in the definitive irradiation of advanced and neck squamous cancer: an RTOG pilot study (#78–02). Int J Radiation Oncology Biol Phys 7: 1703–1708, 1981.

    Article  CAS  Google Scholar 

  33. Wasserman TH, Stetz J, Phillips TL: Radiation Therapy Oncology Group clinical trials with misonidazole. Cancer 47: 2382–2390, 1981.

    Article  PubMed  CAS  Google Scholar 

  34. Sealy R, Williams A, Cridland S, Stratford M, Minchinton A, Hallet C: A report on misonidazole in a randomized trial in locally advanced head and neck cancer. Int J Radiation Oncology Biol Phys 8: 339–342, 1982.

    Article  CAS  Google Scholar 

  35. Arcangeli G, Mauro F, Nervi C: Multiple daily fractionation (MDF) in association with misonidazole (MIS): A two-year experience with head and neck cancer. In: Breccia A, Kimondi C, Adams GE (eds) Advanced topics on radiosensitizers of hypoxic cells. Plenum Press, New York, 1982, pp 249–260.

    Google Scholar 

  36. Horiot JC, VanDenBogaert W, Ang KK, Chaplain G, VanDerSchueren E, Nabid A, Vessiere M: EORTC experience with misonidazole combined with multiple daily fractionated (MDF) radiotherapy. Proc of the European Society for Therapeutic Radiology and Oncology, June 1982.

    Google Scholar 

  37. VanDenBogaert W, VanDerSchueren E, Horiot JC, Chaplain G, Arcangeli G, Gonzalez D, Svoboda V: The feasibility of high-dose multiple daily fractionation and its combination with anoxic cell sensitizers in the treatment of head and neck cancer. Int J Radiation Oncology Biol Phys 8: 1649–1655, 1982.

    Article  CAS  Google Scholar 

  38. Henk Jm: Misonidazole: MRC trials-head and neck. Proc of the European Society for Therapeutic Radiology and Oncology, June 1982.

    Google Scholar 

  39. Bataini JP, Brunin F, AsselainB, Jaulerry C, Brugere J: Experience of using misonidazole in advanced head and neck cancer at the Institut Curie. Proc of the European Society for Therapeutic Radiology and Oncology, June 1982.

    Google Scholar 

  40. Overgaard J, Andersen AP, Jensen RH, Hjelm-Hansen M, Jorgensen K, Petersen M, Sandberg E, Sand-Hansen H: Misonidazole as an adjuvant to radiotherapy of carcinoma of the larynx and the pharynx –A preliminary report of the Danish head and neck cancer study. Proc of the European Society for Therapeutic Radiology and Oncology, June 1982.

    Google Scholar 

  41. Adams GE: Hypoxia-Mediated drugs for radiation and chemotherapy. Cancer 48: 696–709, 1981.

    Article  PubMed  CAS  Google Scholar 

  42. Moulder JE: Dependence of misonidazole radiosensitization on drug and radiation schedules. Int J Radiation Oncology Biol Phys 8: 75, 1982.

    Article  Google Scholar 

  43. Brown JM: Clinical trials of radiosensitizers: What should we expect? Int J Radiation Oncology Biol Phys 10: 475–479, 1984.

    Google Scholar 

  44. Brown JM, Lee WW: Pharmacokinetic considerations in radiosensitizer development. In: Bredy LW (ed) Radiation Sensitizers: Their Use in the Clinical Management of Cancer. New York: Masson Publishing, 1980, pp 2–13.

    Google Scholar 

  45. Brown JM, Workman P: Partition coefficient as a guide to the development of radiosensitizers which are less toxic than misonidazole. Radiat Res 82: 171–190, 1980.

    Article  PubMed  CAS  Google Scholar 

  46. Brown JM: Clinical perspectives for the use of new hypoxic cell sensitizers. Int J Radiation Oncology Biol Phys 8: 1491–1497, 1982.

    Article  CAS  Google Scholar 

  47. Coleman CN, Wasserman TH, Phillips TL, et al: Initial pharmacology and toxicology of intravenous desmethylmisonidazole. Int J Radiation Oncology Biol Phys 8: 371–375, 1982.

    Article  CAS  Google Scholar 

  48. Dische S, Saunders MI, Stratford MRL: Neurotoxicity with desmethylmisonidazole. Br J Radiol 1 54: 156–157, 1981.

    Article  Google Scholar 

  49. Wasserman TH, Coleman CN, Urtasun R, Phillips TL, Strong J: Final Report: Phase I trial of desmethylmisonidazole (DMM) –an hypoxic cell sensitizer. Int J Radiation Oncology Biol Phys 8: 76, 1982.

    Google Scholar 

  50. Wasserman TH, Coleman Cn, Urtasun R, Phillips Tl, Nelson J, Von Gerichten D: Neuropathy of desmethylmisonidazole (DMM): Clinical and pathological description. Int J Radiation Oncology Biol Phys 8: 77, 1982.

    Google Scholar 

  51. Dische S, Saunders MI, Riley PJ, Hauck J, Bennett MH, Stratford MRL, Minchinton Al: The concentration of desmethylmisonidazole in human tumours and in cerebrospinal fluid. Br J Cancer 43: 344–349, 1981.

    Article  PubMed  CAS  Google Scholar 

  52. Chin JB, Rauth AM: The metabolism and pharmacokinetics of the hypoxic cell radiosensitizer and cytotoxic agent, misonidazole, in C3H mice. Radiation Res 86: 341–357, 1981.

    Article  PubMed  CAS  Google Scholar 

  53. Born JL, Hadley WM, Anderson SL, Yuhas JM: Host and hypoxic cell toxicity studies with the terminal reduction product of misonidazole. In: Brady LW (ed) Radiation Sensitizers: Their Use in the Clinical Management of Cancer, New York: Masson Publishing, 1980, pp 79–82.

    Google Scholar 

  54. Stanulovic M: Metabolic and Drug-induced inactivation of vitamin B6. In: Tryfiates GP (ed) Vitamin B6 Metabolism and Role in Growth, Westport, Conn: Foods & Nutrition Press, Inc. 1980, pp 113–136.

    Google Scholar 

  55. Eifel PJ, Brown DM, Lee WW, Brown JM: Misonidazole neurotoxicity in mice decreased by administration with pyridoxine. Int J Radiation Oncology Biol Phys 9: 1513–1519, 1983.

    CAS  Google Scholar 

  56. Williams MV, Chir B, Denekamp J, Minchinton Al, Stratford MRL: In vivotesting of a 2-nitroimidazole radiosensitizer (Ro 03–8799) using repeated administration. In: Sutherland RM (ed) Chemical Modification: Radiation and Cytotoxic Drugs. New York: Pergamon Press, 1982, p 593.

    Google Scholar 

  57. Stratford, Minchinton Al, Hill SA, McNally NJ, Williams MV, Chir B: Pharmacokinetic studies using multiple administration of RO 03–8799, A 2-nitroimidazole radiosensitizer. In: Sutherland RM (ed) Chemical Modification: Radiation and Cytotoxic Drugs. New York: Pergamon Press, 1982, p469.

    Google Scholar 

  58. Saunders MI, Dische S, Fermont D, Bischop A, Lenox-Smith I, Allen JG, Malcolm SL: The radiosensitizer Ro-03–8799 and the concentrations which may be achieved in human tumours: A preliminary study. Br J Cancer 46: 706–710, 1982.

    Article  PubMed  CAS  Google Scholar 

  59. Blumberg AL, Nelson DF, Gramkowski M, et al: Clinical trials of WR2721 with radiation therapy. Int J Radiation Oncology Biol Phys 8: 561–564, 1982.

    Article  CAS  Google Scholar 

  60. Glick JH, Glover DJ, Weiler C, et al: Phase I clinical trials of WR-2721 with alkylating agent chemotherapy. Int J Radiation Oncology Biol Phys 8: 575–580, 1982.

    Article  CAS  Google Scholar 

  61. Fahey RC, Dorian R, Utley JF: New Methods for analysis of WR-24721, WR-1065, and WR-33278. In: Conference on Chemical Modification: Radiation and Cytotoxic Drugs. Key Biscayne, FL, 107: 81, 1981.

    Google Scholar 

  62. Yuhas JM, Spellman JM, Culo F: The role of WR-2721 in radiotherapy and/or chemotherapy. In: Brady LW (ed) Radiation Sensitizers: Their Use in the Clinical Management of Cancer. New York: Manor Publishing, 1980, pp 303–308.

    Google Scholar 

  63. Phillips TL: Rationale for initial clinical trials and future development of radioprotectors. Cancer Clin Trials 3: 165–173, 1980.

    PubMed  CAS  Google Scholar 

  64. Evans RG, Engel C, Wheatley C, Nielsen J: Modification of the sensitivity and repair of potentially lethal damage by diethyldithiocarbamate during and following exposure of plateau-Phase cultures of mammalian cells to radiation and cis-diamminedichloroplatinum (II). Cancer Res 42: 3074–3078, 1982.

    PubMed  CAS  Google Scholar 

  65. Rose CM, Millar JL, Peacock JH, Phelps TA, Stephens T: Differential enhancement of melphalan cytotoxicity in tumpour and normal tissue by misonidazole. In: Brady LW (ed) Radiation Sensitizers: Their Use in the Clinical Management of Cancer. New York: Manor Publishing, 1980, p405.

    Google Scholar 

  66. McNally NJ: Enhancement of chemotherapy agents. In: Sutherland RM (ed) Chemical Modification: Radiation and Cytotoxic Drugs. New York: Pergamon Press, 1982, p593.

    Google Scholar 

  67. Siemann DW: Potentiation of chemotherapy by hypoxic cell radiation sensitizers a review. Int J Radiation Oncology Biol Phys 8: 1029–1034, 1982.

    Article  CAS  Google Scholar 

  68. Brown JM, Hirst DG: The effect of clinically achievable exposure levels of misonidazole on the response of tumour and normal tissues in mouse to alkylating agents. Br J Cancer 45: 700–708, 1982.

    Article  PubMed  CAS  Google Scholar 

  69. Nakatsugawa S, Sugahara T: Effects of inhibitors of radiation-induced potentially lethal damage repair on chemotherapy in murine tumors. Int J Radiation Oncology Biol Phys 8: 1555–1559, 1982.

    Article  CAS  Google Scholar 

  70. Weichselbaum RR, Little JB: Repair of potentially lethal x ray damage and possible applications to clinical radiotherapy. Int J Radiation Oncology Biol Phys 9: 91–96, 1982.

    Google Scholar 

  71. Stratford IJ, Adams GE, Horsman MR, Kandaiya S, Rajaratnam S, Smith E, Williamson C: The interaction of misonidazole with radiation, chemotherapeutic agents or heat. A preliminary report. Cancer Clin Trials 3: 231–236, 1980.

    PubMed  CAS  Google Scholar 

  72. Taylor YC, Evans JW, Brown JM: Mechanism of sensitization of cells to melphalan by hypoxic treatment with misonidazole. Cancer Res 43: 3175–3181, 1983.

    PubMed  CAS  Google Scholar 

  73. Coleman CN, Friedman MK, Jacobs C, Halsey J, Ignoffo R, Leibel S, Hirst K, Gribble M, Carter SK, Phillips TL: Phase I trial of intravenous melphalan plus the sensitizer misonidazole. Cancer Res 1983 (in press).

    Google Scholar 

  74. Yuhas JM: Differential protection of normal and malignant tissues against the cytotoxic effects of mechlorethamine. Cancer Treat Rep 63: 971–976, 1979.

    PubMed  CAS  Google Scholar 

  75. Yuhas JM, Culo F: Selective inhibition of the nephrotoxicity of cis-dichlorodiamminepla- tinum (II) by WR-2721 without altering its antitumor properties. Cancer Treat Rep 64: 57–64, 1980.

    PubMed  CAS  Google Scholar 

  76. Shrieve DC, Harris JW: Protection against cis-dichlorodiammine pt (II) cytotoxicity in vitroby cysteamine. Int J Radiation Oncology Biol Phys 8: 585–588, 1982.

    Article  CAS  Google Scholar 

  77. Wasserman TH, Phillips STL, Roxx G, Kane LJ: Differential protection against cytotoxic chemotherapeutic effects on bone marrow CFU’s by WR-2721. Cancer Clin Trials 4: 3–6, 1981.

    PubMed  CAS  Google Scholar 

  78. Phillips TL, Yuhas JM, Wasserman TH: Differential protection against alkylating agent injury in tumors and normal tissues. In: Proc Natl Conference on Radioprotectors. Academic Press, 1983.

    Google Scholar 

  79. Howell SB, Pfeifle CL, Wung WE, Olshen RA, Lucas WE, Yon JL, Green M: Intraperitoneal cisplatin with systemic thiosulfate protection. Ann Int Med 97: 845–851, 1982.

    PubMed  CAS  Google Scholar 

  80. Howell SB, Pfeifle CE, Wung WE, Olshen RA: Intraperitoneal cis-diamminedichloroplatinum with systemic thiosulfate protection. Cancer Res 43: 1426–1431, 1983.

    PubMed  CAS  Google Scholar 

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© 1984 Martinus Nijhoff Publishers, Boston

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Coleman, C.N., Wasserman, T.H. (1984). Chemical modifiers of radiation and chemotherapy: tumor sensitization and normal tissue protection. In: Wolf, G.T. (eds) Head and Neck Oncology. Cancer Treatment and Research, vol 22. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3816-1_7

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  • DOI: https://doi.org/10.1007/978-1-4613-3816-1_7

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