Alteration of radiotherapy fractionation and concurrent chemotherapy: a new frontier in head and neck oncology?

被引:30
作者
Bernier, J [1 ]
机构
[1] San Giovanni Hosp, Dept Radiat Oncol, Oncol Inst So Switzerland, CH-6504 Bellinzona, Switzerland
来源
NATURE CLINICAL PRACTICE ONCOLOGY | 2005年 / 2卷 / 06期
关键词
altered fractionation; chemoradiation; chemotherapy; head and neck cancer;
D O I
10.1038/ncponc0201
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Despite recent advances in multimodality management of patients with stage III-IV head and neck squamous cell carcinoma, the prognosis in these patients remains disappointing. In an attempt to improve treatment outcome, several teams recently investigated the role of altered fractionation radiotherapy in conjunction with systemic chemotherapy. The controlled trials that investigated this combined approach indicate that, although the magnitude of its effect was less marked for survival indices than for local-regional control, the addition of chemotherapy to altered fractionation regimens results in a clear improvement for these endpoints compared with hyperfractionated or accelerated regimens alone. The key challenge now is to optimize the synergism of these regimens in order to increase their therapeutic ratio in terms of both local-regional and systemic outcomes. This review is a critical appraisal of the real opportunities offered by the application of treatments aimed at increasing the dose intensity of radiotherapy delivered concurrently with cytotoxic drugs.
引用
收藏
页码:305 / 314
页数:10
相关论文
共 43 条
[1]   Intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer [J].
Adelstein, DJ ;
Li, Y ;
Adams, GL ;
Wagner, H ;
Kish, JA ;
Ensley, JF ;
Schuller, DE ;
Forastiere, AA .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (01) :92-98
[2]   Altered fractionation trials in head and neck cancer [J].
Ang, KK .
SEMINARS IN RADIATION ONCOLOGY, 1998, 8 (04) :230-236
[3]  
[Anonymous], 1992, Cancer incidence in five continents
[4]   PRIMARY RADIOTHERAPY OF SQUAMOUS-CELL CARCINOMA OF THE OROPHARYNX AND PHARYNGOLARYNX - TENTATIVE MULTIVARIATE MODELING SYSTEM TO PREDICT THE RADIOCURABILITY OF NECK NODES [J].
BATAINI, JP ;
BERNIER, J ;
ASSELAIN, B ;
LAVE, C ;
JAULERRY, C ;
BRUNIN, F ;
PONTVERT, D .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1988, 14 (04) :635-642
[5]   Altered fractionation and combined radio-chemotherapy approaches: pioneering new opportunities in head and neck oncology [J].
Bernier, J ;
Bentzen, SM .
EUROPEAN JOURNAL OF CANCER, 2003, 39 (05) :560-571
[6]  
BONNER JA, 2004, ASCO 2004 ANN M P S, V5507, pS489
[7]  
Bourhis J, 2004, INT J RADIAT ONCOL, V60, pS190
[8]  
BOURHIS J, 2004, P AM SOC CLIN ONCO S, V22, pS5505
[9]   Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer [J].
Brizel, DM ;
Albers, ME ;
Fisher, SR ;
Scher, RL ;
Richtsmeier, WJ ;
Hars, V ;
George, SL ;
Huang, AT ;
Prosnitz, LR .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (25) :1798-1804
[10]   Choosing a concomitant chemotherapy and radiotherapy regimen for squamous cell head and neck cancer: A systematic review of the published literature with subgroup analysis [J].
Browman, GP ;
Hodson, DI ;
Mackenzie, RJ ;
Bestic, N ;
Zuraw, L .
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 2001, 23 (07) :579-589