Adriamycin: a possible indirect radiosensitizer of hypoxic tumor cells.

Multicellular spheroids grown in vitro provide a convenient model of nodular tumors for experimental tumor therapy studies. Adriamycin was found to inactivate cells grown as spheroids less efficiently than single cells, presumably due to enhanced cellular resistance analogous to the increased radioresistance observed when these cells are grown in close contact. Spheroid growth was retarded by a minimally toxic (0.005 mug/ml) chronic level of adriamycin; irradiation and exposure to that drug concentration were not found to be synergistic. Large adriamycin concentrations (0.5 mug/ml) present during radiation exposure produced a marked "radiosensitization," presumably due to the drug-inhibitng cellular oxygen consumption and thus permitting reoxygenation of the previously hypoxic spheroid cells.