A therapeutic strategy for combined radiotherapy and chemotherapy of experimental solid tumors has been devised. More effective utilization of combined chemotherapy and radiotherapy may be realized clinically if comparable information is obtained in man. The overall treatment efficiency of successive courses of treatment has been determined by a method that defines tumor response quantitatively over an entire spectrum of tumor responses. The findings of this study have shown that an individual tumor that responds well to the first course of therapy will respond well to the second and third courses of combined modality therapy. Various solid tumors in different animal species have demonstrated variability of response to treatment, analogous to the many types of response found clinically. The use of different treatment methods such as radiotherapy and chemotherapy, or combined chemotherapy, indicates that further improvement in management of solid tumors may be realized if the temporal relationship between tumor and patient response is better understood. One of the more promising approaches to the improvement of cancer treatment is the optimal sequencing of different therapeutic modalities to produce maximal effects on the tumor with minimal effects on the host. Many of the questions related to solid tumors in man can only be answered at this time by use of solid tumor models in animals. Such well-defined and rapidly analyzable tumor models can yield quantitative information concerning the time sequence of toxicity to therapy and the kinetics of recovery of host and tumor.Previous reports from these studies (1-6) have demonstrated that recovery from the effects of a large dose of 5-fluorouracil (5-FUra) in rats occurs 10-11 days after treatment. The maximal rate of tumor volume change occurs 12 days after 5-FUra (4). It has also been demonstrated that the rate of proliferation in the tumor is at a maximum 11-12 days after 5-FUra (3). Studies on the solid tumor model hepatoma 3924A indicated that neither radiation alone [375-1500 roentgens (0.10-0.38 C/kg)] nor 5-FUra alone (50-250 mg/kg) would control tumor growth. However, these results suggested that radiation in combination with 5-FUra treatment could in principle transform the management of a chemotherapeutically resistant solid tumor from an untreatable situation to a treatable situation by the combined modality treatment every 11 days until the tumor is eradicated (2).The present report describes the effectiveness of a therapeutic strategy for the sequential use of chemotherapy with radiotherapy. In addition, a method has been developed to compare the treatment efficiency of successive courses of treatment so that successive effects can be distinguished from integrated ones.Abbreviations: 5-FUra, 5-fluorouracil; OTE, overall treatment efficiency. * This is paper no. 5 of a series. Paper no. 4 is ref.
MATERIALS AND METHODSThe analytic methods developed for the evaluation of the effectiveness of single and combined modality therapy on tumor growth cur...