Combinations of Ionizing Radiation and Other Sensitizing Agents

摘要: Several chapters in this book cover broad classes of radiosensitizing agents. Two specific agents, recently used as “radiation enhancers,” are addressed the present chapter. They include redox modulator motexafin-gadolinium (MGd), and alkylating agent temozolomide. Each these agents came to clinical testing through recognition unique preclinical mechanisms data that suggest enhancement radiation cytotoxicity; they share common theme having been clinically tested primarily tumors central nervous system (CNS), a series recent trials, because although therapy (RT) has role managing majority primary secondary CNS neoplasms, outcomes for most patients afflicted by remain poor, furthermore, many ways, an ideal opportunity enhancing efficacy RT combination with radiosensitizers (Patel et al. 2004). The major reasons considering neoplasms candidates radiosensitization follows: 1. cause death due local progression, thereby underscoring need control (Wallner 1989). 2. Evidence exists improving improves survival (Patchell 1990; Noordijk 1994; Mintz 1996; Andrews 3. A dose-response relationship established (Walker 1979). 4. These refl ect rapidly growing population high cell turnover milieu slowly proliferating cells, affording tumor-selective localization several (McGinn 1996). 5. Linear (dose escalation linked lengthening treatment duration) dose-escalation strategies have limited late normal tissue toxicity (Lee 1999). Historically, sensitizers, including S-phase halogenated pyrimidines (Phillips 1995; Prados 1999), oxygen mimetics (Evans 1990), others (Mehta 2001a), without clear evidence benefi t. Recently, very different action gained attention trials (Abraham 1992; Rodrigus 2003; Mehta Suh MGd, modulator, temozolomide, DNA alkylator, focus chapter each is sequence. CONTENTS