oa Editorial [Hot topic: The Association of Radiotherapy and Chemotherapy (Guest Editor: Maurizio Amichetti)]

In recent years, a substantial proportion of patients with solid tumors has received concurrent treatment with radiation and systemic chemotherapy; the association of chemotherapy and radiation is becoming the best current standard therapy option for many patients with locoregionally advanced solid tumors. This issue of Current Drug Therapy reviews for several tumor types the clinical evidence and the state of the current practice in the concurrent use of radiation and drugs. The addition of concurrent chemotherapy to standard radiotherapy has been established to improve locoregional control and overall survival in a variety of solid tumors. Potential interaction between radiation and chemotherapy was described more than a quarter of century ago even though the mechanisms underlying the potentiation of radiation by drugs are still not fully understood. After an introductory paper of Tirindelli-Danesi on the rationale and the biological processes underlying the association, some important examples of tumors treated with radiotherapy and chemotherapy are reported and preclinical and clinical studies discussed. Radiation sensitization has been described for several agents, and many of them have been used even though the most frequently single agent used in clinical practice remains cisplatin. The advent of targeted therapies and the identification of specific molecular profiles associated with different tumor types, will provide to extend the spectrum of chemoradiation schemes available. In the coming years a series of new molecular cancer agents delivered concurrently with radiation will allow oncology practice to increase the options for concurrent treatment regimens. Efficacy and safety in the administration of chemoradiotherapy can be improved by the use of newer and sophisticated radiation delivery modalities that can reduce the amount of irradiated normal tissues and target the tumor more precisely further decreasing the risk of side effects.