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Clinical experience with intravenous misonidazole for carcinoma of the esophagus: results in attempting radiosensitization of each fraction of exposure

Journal Article · · Cancer Invest.; (United States)
; ; ; ; ;
By using intravenous misonidazole, a hypoxic cell radiosensitizer, the authors attempted to test the hypothesis of hypoxia as the basis of the relatively poor results seen with radiation therapy in the treatment of carcinoma of the thoracic esophagus. As the peripheral neuropathy of misonidazole was well recognized, they felt that an adequate dose of misonidazole could be given approximately ten times before peripheral neuropathy would necessitate its discontinuation. Because of a desire to maximize any possible effects of radiosensitization, it was decided to administer misonidazole with each fraction of radiation, attempting to deliver curative radiation therapy with only ten fractions of radiation. The authors thus devised a scheme of radiation consisting of 400 rad twice a week for 5 weeks, a total of 4000 rad. Originally the attempt was made to utilize preoperative radiation therapy and assess the histologic specimens for efficacy. However, major pulmonary toxicity caused revision of that plan. Twenty six patients were treated with radiotherapy alone without surgery, 12 of the patients being randomized to receive intravenous misonidazole with 10 fractions of 400 rad each. In terms of partial response, complete response, local control, and long-term survival, there was no suggestion of any benefit of intravenous misonidazole in these patients. As a consequence, although the number of study patients was small, the investigation was discontinued. Possible explanations for the failure to demonstrate any benefit of misonidazole are discussed.
Research Organization:
National Cancer Inst., Bethesda, MD
OSTI ID:
6353946
Journal Information:
Cancer Invest.; (United States), Journal Name: Cancer Invest.; (United States) Vol. 2:2; ISSN CINVD
Country of Publication:
United States
Language:
English

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550603* -- Medicine-- External Radiation in Therapy-- (1980-)
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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANOXIA
ANTINEOPLASTIC DRUGS
AZOLES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
CARCINOMAS
DIGESTIVE SYSTEM
DISEASES
DRUGS
ESOPHAGUS
FRACTIONATED IRRADIATION
HETEROCYCLIC COMPOUNDS
IMIDAZOLES
IRRADIATION
LUNGS
MEDICINE
MISONIDAZOLE
NEOPLASMS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PATIENTS
RADIATION EFFECTS
RADIOLOGY
RADIOSENSITIVITY EFFECTS
RADIOSENSITIZERS
RADIOTHERAPY
RESPIRATORY SYSTEM
SIDE EFFECTS
THERAPY