Microsoft Word - CHE367BF

Book Reviews J.L. Meyer, J.M. Vaeth (eds.) Radiotherapy/Chemotherapy Interactions in Cancer Treatment Frontiers of Radiation Therapy and Oncology, vol. 26 Karger, Basel 1992. XII + 202 pp.; SFr. 198DM 237.-/$ 158.50 ISBN 3-8055-5493-1 The book is divided into two parts. In the first, comprising 4 articles, basic experimental results on the interactions of radiotherapy and chemotherapy are discussed. The best treatment strategies with respect to dosage and sensitivity of malignant cells to chemotherapy and radiotherapy have been established. The papers are based on experimental results from cell proliferation studies. One interesting assertion is that in chemotherapy, tumor cells respond to fractionated acti-notherapy by repopulation. Further experiments in which the effects on tumors of combining ionizing radiation and cytotoxic drugs (the factor of the effects of chemotherapy and actinotherapy doses on tumor and normal tissues in ratio to the therapeutic gain factor) are discussed. Clarifying the problem of combined acti-nochemotherapy is the essential concern. No less interesting is the knowledge obtained from testing chemotherapeutics on LAF-L mice, and the dependence upon maximal tolerated doses of radiation per square meter or per milligram weight. What is principally under discussion is a clarification of the su-praadditive effect of cytostatics and enhanced injury on normal tissues due to actinotherapy in relation to the specific organ effect of certain cytostatics. The clinical results after combined therapy with radiation and cytostatic drugs, discussed in the second part of the book, are very encouraging. The principal advances are with inoperable selected localizations with a bad prognosis, not only in adults, but also in children. These clinical results are very impressive. In the randomized clinical experiments in head and neck cancer of adult patients (stage III or IV) methotrexate (MTX), 5-flurouracil (5-FU), and cisplatin combined with radiotherapy were used from 1976 to 1980. Some better results are reported in the work of Hank et al. [1], where preoperative radiation therapy – two doses of 3,000 rad – was used followed by 5-FU before each series of radiotherapy. The next paper discusses multimodal therapy, adjuvant as well as neoadjuvant chemotherapy and actinotherapy after surgery, in non-small cell lung cancer. The results, however, are still inconclusive. There is further very interesting information about utilizing combined therapy in gastrointestinal cancer: esophageal, gastric, pancreatic and anorectal. The most interesting model of this combined chemora-diotherapy was reported recently by Bayfield et al. [2] using high doses of 5FU and its protracted continuous infusion in combination with radiation therapy. Recently, socalled intraoperative electron beam boost (IORT-EB) therapy using electron radiation from the linear accelerator has been introduced into the radiation therapies. This method requires special adaptation of the operating theater.