Centre de protonthérapie, BP 65, 91402 Orsay Cedex.
Clinical trials carried out during the last decade have given clear indication on the potential of concomitant association of radiotherapy and chemotherapy for improving local control and survival rates in the management of locally advanced solid tumours. In most trials, cisplatin was used alone or in combination with other drugs. Meta-analysis pointed to the potential of these combinations in head and neck, lung, cervical and œsophagus cancers. The interaction of radiotherapy with chemotherapy for these solid tumours appears to depend primarily on the time-scheduling of radiation versus drug exposure and on radiation fractionation. Major improvements aiming at increasing therapeutic index, are expected from studies on the mode of action of drugs and on the mechanisms of acute toxicity of drugs and radiation.