Chemotherapy in Malignant Disease
نویسنده
چکیده
IN the last I5 years chemotherapy has come to be recognized as playing an essential part in the palliative management of a few types of malignant disease. The natural and synthetic sex hormones and their derivatives are now in general use in the routine treatment of mammary and prostatic carcinoma; systemic chemotherapy by means of the so-called antimetabolites is the main form of treatment in the acute leukmmias; and the biological alkylating agents are equal in importance to radiotherapy in the treatment of the chronic leukemias, some malignant lymphomata, and generalized Hodgkin's disease. The place of systemic chemotherapy in these very restricted fields is generally acknowledged, but there is less agreement on its role in other and commoner forms of malignant disease. The value of the alkylating agents in the treatment of ovarian adenocarcinoma is becoming more widely known (Coonrad and Rundles, I959), but it is perhaps too early to define the precise indications for using them. It is unfortunate that many of the conditions in which chemotherapy is of most value are rarities, such as chorioncarcinoma, which may respond to the antimetabolites methotrexate and mercaptopurine (Buckle, I959; Hertz, Bergenstal, Lipsett, Price and Hilbish, I958), and nephroblastoma and perhaps other embryonal tumours in which suitablecombinations of surgery, radiotherapy and cytotoxic antibiotics like actinomycin D and mitomycin C are reported to give far better results than were obtained before chemotherapy was introduced (Farber, D'Angio, Evans and Mitus, I960). The common forms of malignant disease, particularly the gastro-intestinal carcinomata, are almost all resistant to chemotherapy, while carcinoma of the bronchus and breast are significantly influenced by cytotoxic drugs only in doses close to or within the lethal range.
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تاریخ انتشار 2008