The administration of chemotherapeutic agents by continuous infusion with concomitant radiation therapy heralds a new approach in the treatment of cancer. This comprehensive book on the subject includes, besides a discussion of its scientific basis, the most promising clinical data on the use of continuous infusion chemotherapy and radiation. Thus, it is an important update for clinical investigators involved in frontline research as well as for practicing physicians participating in the direct care of cancer patients. The contributions include the latest results of this new approach in a number of tumor sites. There is a detailed description of the principles of radiosensitization for malignant tumors and radioprotection for normal tissues; these are the principles which have led to concrete clinical applications. There is also a presentation of the most recent data on the beneficial effects resulting from the administration of commonly used drugs, such as 5-fluorouracil, cisplatinum and adriamycin, with concomitant radiation therapy. Much of the data has never before been published. The wealth of information in this volume makes it a valuable reference; at the same time it gives practicing physicians a detailed presentation of various therapeutic regimens which they could administer in their daily clinical practice. In the future, this innovative cancer treatment may lead to the decreased need for radical surgery and the increased ability to preserve organ function.
The Development of Chemotherapy Drugs as Radiosensitizers: an Overview.- Section I Principles of Infusion Chemotherapy.- 1. Experimental Rationale for Continuous Infusion Chemotherapy.- 2. Combination Chemotherapy by Infusion in Hematological Malignancies.- 3. Combination Chemotherapy by Infusion in Solid Tumors.- 4. Admixtures of Chemotherapy Agents by Continuous Infusion.- 5. Time-Specified Delivery of Chemotherapy by Implantable Programmable Pumps - Preliminary Data on 5-Fluoro-2?-deoxyuridine.- 6. Advances in the Technology of Continuous Infusion.- Section II Radiosensitization and Radioprotection.- 7. Hypoxic Cell Sensitizers.- 8. Glutathione, a Determinant of Response to Cancer Treatment.- 9. Radiosensitization of Nonhypoxic Cells by Halogenated Pyrimidines.- 10 Perfluorocarbon Emulsion and Oxygen with Concomitant Radiation Therapy in Primary High Grade Brain Tumors.- 11. Chemo- and Radioprotection: Clinical Trials Combining WR-2721 with Cisplatin and Cyclophosphamide.- 12. Biological Modifiers’ Potential for Radioprotection.- Section III 5-Fluorouracil Radiopotentiation and Its Modulation by Other Agents.- 13. Theoretical Basis and Clinical Applications of 5-Fluorouracil as a Radiosensitizer - an Overview.- 14. Efficacy of 5-Fluorouracil by Continuous Infusion as a Radiopotentiator - Anal and Rectal Carcinoma.- 15. Hepatic Metastases from Gastrointestinal Malignancies and Hepatocellular Carcinoma.- 16. The Use of Infusional 5-Fluorouracil, Mitomycin C, and Radiation as the Primary Management of Esophageal Cancer.- 17. Concomitant Radiation and 5-Fluorouracil for Head and Neck Cancer.- 18. Continuous Intravenous 5-Fluorouracil with Hydroxyurea and Concomitant Radiotherapy for Advanced Head and Neck Cancer.- 19. Treatment of Advanced Carcinoma of the Bladder with Concomitant 5-Fluorouracil Infusion and Radiation.- 20. Combined 5-Fluorouracil and Irradiation for the Treatment of Invasive Bladder Cancer.- 21 Protracted (Continuous 5-Fluorouracil) Infusion with Concomitant Radiation Therapy: Indications and Results.- Section IV Radiopotentiation by Cisplatin in Continuous Infusion.- 22. Radiopotentiation in a Murine Tumor (MTG-B) by Continuous Infusion Platinum.- 23. Locally Advanced Paranasal Sinus and Nasopharyngeal Cancers - Effects of Hyperfractionated Radiation and Concomitant Continuous Infusion Cisplatin.- 24. Cisplatin plus Radiotherapy in Bladder Cancer.- 25. Small-Cell Carcinoma of the Lung.- 26. Non-Small-Cell Carcinoma of the Lung.- Section V Radiopotentiation by Combined Cisplatin and Continuous Infusion 5-Fluorouracil.- 27. Head and Neck Cancer.- 28. Combined Cisplatin and Concomitant Continuous Infusion 5-Fluorouracil and Accelerated Radiation in Advanced Head and Neck Cancer.- 29. Toxicity of Combined Cisplatin, Infusional 5-Fluorouracil and Concomitant Radiotherapy in Advanced Head and Neck Cancer.- 30. Esophageal Carcinoma.- 31. Adenocarcinoma of the Gastroesophageal Junction: Preoperative Cisplatin and Concomitant Continuous Infusion 5-Fluorouracil and Radiation Therapy.- 32. Efficacy of 5-Fluorouracil by Continuous Infusion and Other Agents as Radiopotentiators for Gynecological Malignancies.- Section VI Efficacy of Continuous Infusion Adriamycin as a Radiation Potentiator.- 33. Concomitant Continuous Infusion Adriamycin and Radiation: Evidence of Synergistic Effects in Soft Tissue Sarcomas.- 34. Infusion Adriamycin and Radiation in Hepatomas.- List of Contributors.