Prolonged venous infusion of cisplatin and concurrent radiation therapy for lung carcinoma: a feasibility study

Article Abstract:

When lung cancer has not yet spread, but is not operable, radiation therapy is the treatment of choice. Unfortunately, the success rate of this treatment is not satisfactory. Fifty or 60 percent of patients may be expected to respond to radiotherapy. Of those, only 1 in 20 will enjoy long-term survival. One way in which this success rate might be improved is through the use of chemotherapeutic agents simultaneously with radiotherapy to sensitize the cancer to the killing effects of the radiation. Since cisplatin has been demonstrated to enhance the cytotoxic effects of radiation, this drug was selected for use in a study involving 50 patients with inoperable lung cancer. Cisplatin was given by continuous infusion rather than by single injection, as this was determined to be the most advantageous method of administration. The continuous infusion was administered over seven weeks; during the first three weeks and the last two weeks, the patients also received doses of 500 cGy five days per week (a Gy, or Gary, is one Joule of energy absorbed per kilogram of tissue). Eighty-six percent of the patients had a complete or partial response within 11 weeks. The overall survival at one year was 64 percent, and the average time to progression was 9.4 months. Both the response and the survival rates were high for lung cancer, and the method seems to warrant further evaluation. Less dramatic, but no less important, is the fact that the infusion pump method of drug delivery was reliable over an extended period of time. Less than 1 percent of the estimated infusion time was lost due to problems with the pump or the catheter providing access to the vein. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Chemotherapy, Lung cancer, Cisplatin

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Accelerated hyperfractionation radiation therapy for carcinoma of the nasopharynx: techniques and results

Article Abstract:

Many decisions must be made in developing a program of radiotherapy for a cancer patient. In addition to the dose of radiation, an appropriate schedule of irradiation must be developed which balances the tumoricidal benefits with the potentially serious side effects of the treatment. One approach is the use of hyperfractionation, the application of smaller individual doses of radiation on a more frequent schedule. A twice-a-day (BID) schedule, rather than the more common once-a-day (QD) schedule, was used to treat 60 patients with cancer of the nasopharynx. The survival of these patients was compared with the case histories of patients treated on a QD schedule before the study began. Overall, 85 percent of the patients treated with a BID schedule achieved local control of the cancer over a five-year period. Historically, patients treated with QD schedule had a 52 percent rate of local control over five years. The patients received doses of radiation in two daily doses of 1.6 Gy each, separated by four hours. After two weeks on this schedule, the patient rested for two weeks to recover from the inflammation of the mucous membranes which accompanies irradiation of the head. A second round of BID radiation was then administered. Myelitis, brain necrosis, and ankylosis of the mandibular joint, which may be side effects of radiation to the head, were not observed in any patient. The results indicate that twice-a-day hyperfractionation radiotherapy is an effective treatment for cancer of the nasopharynx; a randomized clinical trial should be instituted to establish this point firmly. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Nose cancer

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