[Combination of anthracyclines with radiotherapy. Value and problems]

Association between radiotherapy and anthracyclines (especially adriamycin) early showed major toxicity on critical normal tissues so that its antitumor activity was concealed. This toxicity proved to be acute toxicity, recall phenomenon and cardiac toxicity. Clinical and experimental studies showed synergistic effect when drug and radiation are administered concomitantly and additive effect in sequential administration. So concomitant association must be rejected. The main point is the time interval between adriamycin injection and radiotherapy (at least seven days). These conditions are respected when alternating treatment schedule is applied: radiation split courses are integrated between two chemotherapy cycles including adriamycin. At this time new anthracycline analogs were not associated to radiotherapy.