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1、AlternatingChemotherapy【关键词】,Head,and,neck,cancer,#8226;,Chemoradiation LEARNINGOBJECTIVES Afterpletingthiscourse,thereaderotherapyandradiotherapyforthetreatmentoflocoregionallyadvancedheadandneckcancer. Describetherationaleforusingalternatingchemotherapyandradiotherapyinthem
2、anagementofheadandneckcancer. Explainoradiationshouldpreferablybemanagedbyanexperiencedstaff. Assesstheroleplayedbydifferentdrugsinthedevelopmentofmucositisinanalternatingchemotherapyandradiotherapybinedtreatment. ABSTRACT Rapidlyalternatingchemotherapyandradiotherapy(ACR)is
3、aminorvariationofconcurrentchemoradiation(CCR).Thisschedulinghasbeentestedinadvancedheadandneckcancerandhasshoerandomizedtrialsarginallygreatertoxicity.ThispaperrevieoradiationaddstotoxicitylessthanCCRandresultsinparable3-yearoverallsurvivalrates.Inconclusion,ACRcouldbeasactivea
4、s,andpossiblylesstoxicthan,CCR.parativetrialsarehighlyremended. INTRODUCTION Oneofthefirstrandomizedtrialsshooradiationinadvancedheadandneckcancerotherapyandradiotherapy(ACR)[1].ACRisaminorvariationofconcurrentchemoradiation(CCR)aimedatminimizingtoxicity[2].Thisschedulingalloe
5、ntofthetumor,inisteredduringthepausesbetotherapy. LooneyandHopkins[3]ultaneousadministrationofbothtreatmentmodalitiesexperimentalsolidtumorsystems. Decreasingchemoradiation-inducedtoxicityisamajorobjectiveinheadandneckcancer.Chemoradiationhasproventobesuperiortoradiotherapyalo
6、ne[4],buttreatment-relatedtoxicitiesarehigher,andanexpertstaffisrequiredtodeliverthisplextreatmentmodality[57].Poormanagementoftoxicityleadstoalterationsofdosesorschedulingofradiationand/orchemotherapy,thuspromisingthepotentialgainintreatmentefficacy.Radiotherapyalonemaybeamorea
7、ppropriatetreatment[6]echanismofactionandtheclinicalresultsofACRintermsoftoxicityandefficacy,andtoexplorethereasonswhy678thisapproachisunderinvestigatedbytheinternationalscientificmunity. ACR:SCHEDULESTESTEDINRANDOMIZEDTRIALS Inthepasttilarbecauseradiotherapyotherapyinallstudi
8、es,butthechemotherapyregimensemployedycin(Bleno
