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Combinations of Platinum Compounds and Ionizing Radiation

  • Carsten Nieder
  • Florian Lordick
Part of the Medical Radiology book series (MEDRAD)

6.6 Conclusion

The use of platinum compounds concomitant to radiotherapy is based on sound rationales and has resulted in development of several clinically successful combined modality regimens. Optimization of such regimens was accomplished mainly in clinical trials. Systematic work in a broader panel of preclinical tumor models suggests that more than additive effects can be obtained with fractionated radiotherapy when the drug is given shortly before radiation. Importantly, normal tissues do not exhibit the same degree of sensitization. With the advent of improved molecular characterization of tumor and host factors, it is hoped to identify the most suitable regimen for each individual patient. Nevertheless, it is emphasized that within a heterogeneous tumor (different molecular features of the cells, different perfusion, different drug sensitivity, changes of such factors over time) heterogenous drug concentrations and treatment effects have to be anticipated, which are very difficult to model or predict. In addition, each component of the treatment protocol might influence both the microenvironment of the tumor and the sensitivity to the other components, as exemplified by radiation-induced cisplatin resistance. These factors complicate the comparison and optimization of different drug administration protocols. The problems of drug access to the tumor cells, efflux, inactivation, toxicity, etc., are being addressed by advances in pharmacogenetics, delivery routes, development of new generation platinum compounds, and modifiers of metabolism and damage repair.

Keywords

Radiat Oncol Biol Phys Platinum Compound Platinum Drug Squamous Cell Carcinoma Cell Line Radiat Biol 
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 2006

Authors and Affiliations

  • Carsten Nieder
    • 1
  • Florian Lordick
    • 2
  1. 1.Department of Radiation OncologyKlinikum rechts der Isar der Technischen Universität MünchenMunichGermany
  2. 2.Third Department of Internal Medicine (Hematology/Medical Oncology)Klinikum rechts der Isar der Technischen Universität MünchenMunichGermany

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