Evaluation of remission of progressive tumors treated with a simultaneous combination of radiation and platinum therapy

UNLABELLED: Since January 1982, we have treated in a phase-II study 28 patients with a low-dose cis-platinum therapy combined with radiotherapy. We wanted to study the effect of reduced doses of cis-diamino-dichloroplatinum (II) in three different dose patterns: 1. "higher" dosage (150 mg/m2 within six weeks), single dose: 25 mg/m2 one time per treatment week), 2. "medium" dosage (80 mg/m2 within six weeks), single dose: 20 mg/m2 two times weekly during the first, fourth, seventh, and tenth treatment week, 3. "lower" dosage (75 mg/m2 within six weeks), single dose: 12.5 mg/m2 three times weekly during the first, fourth, seventh, and tenth treatment week. In one patient group the simultaneous radiotherapy was performed with a tumoricide dose of 2 Gy single dose with 4 fractions per week in two series (first series about 40 to 48 Gy tumor dose, pause of three to four weeks, second series about 16 Gy focal dose). The other group received palliative radiation doses (10 to 35 Gy tumor dose in one series), and the total platinum doses were lower corresponding to the shorter irradiation time. All patients were in advanced or recurrent stages of the disease. They suffered from different carcinomas and sarcomas with measurable parameters of response. RESULTS: 1. Manifestations beyond the irradiation field showed no remission. Within the irradiation field, all cases responded (CR/PR) for at least two months. 2. There was no reliable dependence from the platinum dose. A tendency in favor of higher single doses could be supposed. The response of even extreme palliative cases with low radiation and platinum doses was surprising. Limitating toxicities were not observed.