Radioprotectors and Chemoprotectors in the Management of Lung Cancer

  • Ritsuko Komaki
  • Zhongxing Liao
  • James D. Cox
  • Kathy A. Mason
  • Luka Milas
Part of the Medical Radiology book series (MEDRAD)


Lung cancer is the leading cause of cancer death in most developed countries. The prognosis remains poor with an overall survival rate at 5 years of only about 15%. Between 70 and 85% of all cases are histologically classified as non-small cell lung carcinoma (NSCLC). Radiation therapy has traditionally been the treatment of choice for locally advanced disease and medically inoperable early stage NSCLC. However radiation therapy alone was not effective treatment for patients with locally advanced NSCLC. The addition of cytotoxic drugs to radiotherapy considerably improves treatment outcome, and the combination of chemotherapy with radiotherapy has become common practice for the treatment of locally advanced lung cancer. The addition of chemotherapy to radiotherapy has two principal objectives: one, to increase the chance of local tumor control and two, to eliminate metastatic disease outside of the radiation field. Several randomized trials have shown improvement of local control and survival by application of concurrent chemotherapy rather than sequential chemotherapy followed by radiation treatment. This combined treatment approach results in median survival times of 13 to 14 months and survival rates at 5 years as high as 15 to 20%. These improvements have been achieved by using standard chemotherapeutic agents, primarily cisplatin-based drug combinations. However, concurrent chemoradiotherapy has increased significant normal tissue toxicity such as esophagitis and pneumonitis. Therefore normal tissue protectors without protective cancer cells became necessary to improve therapeutic ratio. We will discuss mechanism and efficacy of Amifostine to protect normal tissue followed by other normal tissue protectors or molecular targeted treatment without increasing normal tissue damage e.g., prostanoids (COX-2) inhibitors, Growth factor and Cytokines inhibitors, Basic and other inhibitors targeting Fibroblast Growth Factor, Karatinocyte Growth Factors, Epidermoid Growth Factor Receptor, Pentoxifylline, Angiotensin-Converting Enzyme Flavopiridol Poly(ADP-Ribose) Polymerase, Bcl-2 , and Efaproxaril, as well as Radioprotective Gene Therapy/ Antioxidant Therapy: and Superoxide Dismutase


Radiation Therapy Oncology Group PARP Inhibitor Local Tumor Control Radiation Injury Esophageal Squamous Cell Carcinoma Cell 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Berlin Heidelberg  2011

Authors and Affiliations

  • Ritsuko Komaki
    • 1
  • Zhongxing Liao
    • 1
  • James D. Cox
    • 1
  • Kathy A. Mason
    • 2
  • Luka Milas
    • 2
  1. 1.Department of Radiation Oncology, Unit 97The University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Experimental Radiation OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA

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