Radiotherapy in combination with misonidazole and ACNU (1-(4 amino-2 methyl-5 pyrimidinyl) methyl-3-(2 chloroethyl)-3-nitrosourea hydrochloride)

Misonidazole and ACNU were intermittently combined one or several times with radiotherapy. Misonidazole was orally administered with a dose of 1.5g/m2 4 hours before irradiation. ACNU with a dose of 60mg/m2 mixed with predonisolone (40 mg) was intravenously injected between misonidazole and irradiation. Irradiation was carried out with the fractionation of 120 rads per fraction and 5 fractions per week in lung cancer and of 200 rads per fraction and 3 fractions per week in head and neck cancer. Twenty lung cancer patients and 13 head and neck cancer patients were treated from July, 1980 to April, 1982. In lung cancer, BAI (bronchial artery infusion) of adriamycin was added besides the above-mentioned treatment. Complete plus partial response rate of lung cancer was 85%, one year survival rate by Kaplan-Meier's method 65 +- 10.7% and two year survival rate 39.8 +- 12.2%, which were promising. In head and neck cancer, complete plus partial response rate was 76.9%, and one year survival rate 67.3 +- 13.6%. Head and neck cancer contained many recurrent and many advanced stage cases. Side effects of this treatment were nausea, vomiting and thrombocytopenia due to ACNU. These were all transient. Any peripheral neuropathy due to misonidazole was not observed in this treatment scheme. The fractionation in multomodality therapy is discussed and the mechanism of chemosensitization is bibliographically discussed. (author)