Biological basis for the interaction of chemotherapeutic agents and radiation therapy
Biological basis for the interaction of chemotherapeutic agents and radiation therapy
复制标题
化疗药物与放射治疗相互作用的生物学基础
作者：
K. Fu
放化疗联合治疗的最终目的是提高肿瘤的治愈率。当化疗与放疗结合时，由于以下原因，可能会出现治疗效果的改善：（1）空间协同作用;（2）增强肿瘤反应，同时减少或不增加正常组织损伤;（3）减少正常组织损伤，同时减少或不减少肿瘤反应。化疗剂和放射之间相互作用导致增强效应的可能机制包括：（1）剂量反应曲线斜率的变化，（2）亚致死损伤修复的累积或抑制减少，（3）潜在致死损伤的恢复减少，（4）细胞动力学的扰动，敏感细胞周期阶段和增殖状态的细胞比例增加，（5）减少肿瘤体积和改善血液供应，导致再氧合和募集，并增加放射敏感性和化学敏感性，和（6）增加药物递送和摄取。联合效应可能受以下因素影响：（1）肿瘤和正常组织类型，（2）药物类型，（3）药物剂量和方案，（4）药物和放射给药之间的时间顺序，（5）放射剂量和分次方案，以及（6）放射剂量率。大多数实验和临床数据表明，增强的肿瘤效应最常由简单的加和性引起，因此不需要药物和辐射之间的直接相互作用，而增强的正常组织效应最常在药物给药时间接近辐射时观察到。因此，为了获得最佳治疗效果，以顺序或交替的方式而不是同时施用化疗药物和放射似乎更有利。
The ultimate goal of combining chemotherapy and radiotherapy is to improve the therapeutic ratio. When chemotherapy is combined with radiotherapy, improved therapeutic effects may occur as a result of the following: (1) spatial cooperation; (2) enhancement of tumor response with less or no enhancement of normal tissue injury, and (3) diminution of normal tissue injury with less or no diminution of tumor response. Possible mechanisms of interaction between chemotherapeutic agents and radiation that result in an enhanced effect include (1) changes in the slope of the dose response curve, (2) decreased accumulation or inhibition of repair of sublethal damage, (3) decreased recovery from potentially lethal damage, (4) perturbation in cell kinetics with an increase of proportion of cells in the sensitive cell cycle phase and proliferative state, (5) decreased tumor bulk and improved blood supply leading to reoxygenation and recruitment and increased radiosensitivity and chemosensitivity, and (6) increased drug delivery and uptake. The combined effects may be influenced by (1) tumor and normal tissue type, (2) drug type, (3) drug dose and schedule, (4) time sequence between drug and radiation administration, (5) radiation dose and fractionation schedule, and (6) radiation dose rate. Most experimental and clinical data suggest that enhanced tumor effects most often result from simple additivity and therefore do not require direct interaction between drug and radiation, whereas enhanced normal tissue effects are observed most often when drugs are administered in close temporal proximity to radiation. Thus, for the optimal therapeutic effect, it would seem more advantageous to administer chemotherapeutic drugs and radiation in a sequential or alternating manner rather than simultaneously.
肿瘤大小：影响肿瘤对联合治疗方式反应的等效应分析的因素。
DOI：
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发表时间：
1980
期刊：
The British journal of cancer. Supplement
影响因子：
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作者：
Siemann,DW
通讯作者：
Siemann,DW