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).
KeywordsNeck Cancer Cytotoxic Drug Radical Radiation Squamous Cell Cancer Intravenous Bolus Injection
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