Year: 1980
Type: article
Abstract: malignant processes did develop, by contrast, in others of their patients, who had received irradiation alone or in combination with various other multiple-agent chemotherapy regimens, in conformity with data presented by several other investigators.1-3A possible explanation for these results lies in the observation reported by the Late Effects Study Group, which found that actinomycin D appeared to decrease the risk of radiationassociated second malignant neoplasms by a factor of 7.4 Adriamycin, one of the agents in ABVD, resembles actinomycin D in certain fundamental and clinical ways.Both are antibiotics that intercalate-in the DNA molecule and both are radiation enhancers and reactivators.5t; Thus it is possible that adriamycin is acting like actinomycin D in protecting against radiation-associated cancers.This possibility is given some credence in view of the fact that 2 60, of the patients reported by Mr Valagussa and his colleagues who received only irradiation developed second tumours within five years and 14 9o0 did so within 10 years.Of additional interest is the fact that second tumours were observed in irradiated patients given the five-drug regimen MABOP.The latter contains adriamycin, but also includes nitrogen mustard and procarbazine.The latter two alkylating agents have been widely held to be oncogenic in their own right.7 8 This suggests that adriamycin-if it does act like actinomycin D in protecting against second tumours following irradiation-is not efficient for this purpose when alkylating agents are concerned.It will be important to see whether the experience accumulated in other groups of irradiated patients who receive adriamycin with or without alkylating agents with high oncogenic potential duplicate the very in- terestinig and thought-provoking results reported by the Milan investigators.The implications regarding choice of treatment for patients requiring combined chemotherapy and radiation therapy are obvious.
Source: BMJ
Authors: V M Yates, R E Kerr
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2065249453