ABSTRACT
Today, combined radiochemotherapy is firmly established in clinical practice for a wide spectrum of tumours. Randomized trials have shown that in many cases, this strategy may lead to better local control and survival than radiotherapy alone. In this chapter we emphasise that, despite their proven benefit, currently available chemotherapeutic drugs are far from being perfect for combining with radiotherapy. Tumour cell kill by chemotherapy at clinically achievable doses is minor compared to that caused by radiation. Only in a relatively small proportion of patients is chemotherapy sufficiently effective to destroy subclinical metastatic deposits. Normal tissue toxicity is frequently increased after combined radiochemotherapy, which may limit doses of drugs or radiation. For these reasons it is obvious that more effective and less toxic substances are needed to further improve the results of systemic therapies combined with radiation.
