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Radiobiology in Radiotherapy pp 177–199Cite as

Combined Treatment with Radiation and Anti-Cancer Drugs: Experimental and Clinical Results

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Abstract

The combination of radiotherapy and chemotherapy for the treatment of patients with malignant tumours has found increasing use during the last decade. The main aims of this combined treatment approach are to increase the control of primary tumours and to eradicate microscopic metastases. The first of these aims, improvement of local control, can be attempted in two ways: (a) giving the chemotherapy separated in time from the irradiation, or (b) administering cytotoxic drugs during the irradiation period in order to obtain a radiosensitizing effect. With the first approach only additive cell killing is sought, while using cytotoxic agents as radiosensitizers may cause supra-additive cell killing by specific interactions between the two agents. In either situation the chemotherapy will also have an effect on microscopic metastases. Additive or supra-additive results of a combined treatment can, however, also occur in normal tissues. The anticipated therapeutic gain will then be decreased due to additional complications in normal tissue or even the induction of second malignancies. It is therefore important that, before introducing promising new combinations of radiotherapy and chemotherapy, studies in animals should be carried out to quantitate the effect of the combination on normal tissues as well as on tumours. We will describe experimental results for combined treatments with cisplatin and X-rays, concentrating mainly on results obtained in our own laboratory, in order to illustrate some general principles of combined modality therapy. This will be followed by an evaluation of clinical trials in which the combination of irradiation and chemotherapy has been investigated.

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Authors
  1. H. Bartelink
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  2. A. C. Begg
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  3. L. Dewit
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  4. F. A. Stewart
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Editors and Affiliations

  1. University of Cambridge School of Clinical Medicine, Department of Clinical Oncology and Radiotherapeutics, Addenbrooke’s Hospital, Hills Road, CB2 2QQ, Cambridge, UK

    Norman M. Bleehen FRCP, FRCR, Honorary FACR (Cancer Research Campaign Professor of Clinical Oncology, Honorary Director MRC Clinical Oncology and Radiotherapeutics Unit) (Cancer Research Campaign Professor of Clinical Oncology, Honorary Director MRC Clinical Oncology and Radiotherapeutics Unit)

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© 1988 Springer-Verlag Berlin Heidelberg

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Bartelink, H., Begg, A.C., Dewit, L., Stewart, F.A. (1988). Combined Treatment with Radiation and Anti-Cancer Drugs: Experimental and Clinical Results. In: Bleehen, N.M. (eds) Radiobiology in Radiotherapy. Springer, London. https://doi.org/10.1007/978-1-4471-1603-5_16

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  • DOI: https://doi.org/10.1007/978-1-4471-1603-5_16

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1605-9

  • Online ISBN: 978-1-4471-1603-5

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