Concomitant Radiation and 5-Fluorouracil for Head and Neck Cancer
One of the first trials of concomitant radiation and chemotherapy to show any improvement in survival rates included the administration of 5- fluorouracil (5-FU) during the course of radiation treatment of oral and oropharyngeal cancers (Lo et al. 1976). Nevertheless, while the premise that the cure rates for squamous cell cancers of the head and neck can be increased by the addition of chemotherapy to radiotherapeutic and surgical protocols is attractive, any clear demonstration of benefit from such combinations remains elusive. If a cytotoxic drug has demonstrable activity against the cancer being treated, combining such a drug with radiation might improve local control rates and reduce the incidence of distant metastases. If there is any synergistic interaction between the drug and radiation, a greater level of control might be achieved in tissues exposed to both agents than would result from the additive cytotoxic effects of the combination (Steel and Peckham 1979). However, if synergistic or additive effects also increase damage to normal tissues, the therapeutic ratio could be adversely affected by combined modality therapy. The many difficulties in interpreting the literature relating to laboratory studies and to clinical trials of combinations of radiation and cytotoxic drugs have been reviewed recently (Fu 1985; Iscoe 1987; Steel 1988; Tannock 1989).
KeywordsToxicity Oncol Pyrimidine Palmitate Noma
Unable to display preview. Download preview PDF.
- Cummings BJ, Keane TJ, Harwood AR, Thomas GM (1986) Combined modality therapy with 5-fluorouracil, mitomycin C and radiation therapy for squamous cell cancer. In: Rosenthal CJ, Rotman M (eds) Clinical applications of continuous infusion chemotherapy and concomitant radiation therapy. Plenum, New York, pp 133–147CrossRefGoogle Scholar
- Dionet C, Rozan R, Achard JL et al. (1988) Sequential combination of 5-fluorouracil, cis-platinum and irradiation. 1. Advanced head and neck cancers. Radiother Oncol 11: 123–131Google Scholar
- Fletcher GH, Suit HD, Lindberg RD, Howe CD, Samuels ML, Jesse RH, Smith JP (1967) Chemotherapy as an adjuvant to surgery and radiation therapy. Proceedings 9th International Cancer Congress. UICC Monograph vol 10. Springer, Berlin Heidelberg New York, pp 177- 184Google Scholar
- Fu KK (1979) Normal tissue effects of combined radiotherapy and chemotherapy for head and neck cancer. Front Radiat Ther Oncol 13: 113–132Google Scholar
- Iscoe N (1987) Chemotherapy of head and neck cancer. Clin Oncol 5: 575–593Google Scholar
- Keane TJ, Harwood AR, Beale FA, Cummings BJ, Payne DG, Rawlinson E (1985) A pilot study of mitomycin C and 5-fluorouracil infusion combined with split course radiation therapy for advanced carcinomas of the larynx and hypopharynx. J Otolaryngol 15: 286–288Google Scholar
- Maguire LC, Mendiondo OA, Medina WD, Cronin JD, Wheeler BM, Bartmas S (1987) Improved disease free survival in advanced head and neck carcinoma. Head and Neck Oncology Research. Kugler, Amsterdam, pp 271–274Google Scholar
- Marshall RS, Rauth AM (1988) Oxygen and exposure kinetics as factors influencing the cytotoxicity of por- firomycin, a mitomycin C analogue, in Chinese hamster ovary cells. Cancer Res 48: 5655–5659Google Scholar
- Marzecki Z, Krygier-Stojalowska A, Zaborek B, Mietkiewski J, Meyer A, Mazuryk R, Torbe Z (1980) Early clinical experience with radiation therapy of the advanced tumors following synchronization of the cell cycle with 5-fluorouracil. Radiobiol Radiother 21: 417–423Google Scholar
- Sharp TR, Frankel SS, Byfield JE, Callipari F, Hornbeck CL (1983) Combined infusional 5-FU and x-ray therapy for advanced head and neck cancer - scheduling of radiosensitizing programs. Proc Am Soc Clin Oncol 2: 168Google Scholar
- Wendt TG, Wustrow TPU, Hartenstein RC, Rohloff R, Trott KR (1987) Accelerated split-course radiotherapy and simultaneous cis-dichlorodiammine-platinum and 5- fluorouracil chemotherapy with folinic acid enhancement for unresectable carcinoma of the head and neck. Radiother Oncol 10: 277–284PubMedCrossRefGoogle Scholar