癌的时间化疗研究进展  

ADVANCE IN CIRCADIAN CHEMOTHERAPY OF CANCER

作　　者：曾昭贤[1] 刘光谱[1] 

机构地区：[1]华西医科大学化疗药理研究室,成都中医药大学中医基础理论研究室

出　　处：《中国临床药理学杂志》1996年第4期242-248,共7页The Chinese Journal of Clinical Pharmacology

摘　　要：动物及临床试验提供了大量有关抗癌药昼夜节律依赖性作用的资料，对至少２０种抗癌药物的合理应用有参考意义，常用抗癌药中，蒽环类抗生素阿霉素、哌喃阿霉素，主张在早上给药毒性较低而疗效更高；铂类化合物顺铂、卡铂及草酸铂在下午及傍晚给药最为安全有效；抗代谢药５－ＦＵ、ＦＵＤＲ、Ａｒａ－Ｃ、６－ＭＰ及ＭＴＸ最好的耐受性和疗效是在傍晚或夜间睡眠期给药；在对激素、细胞因子及其它生物反应调节剂的给药方案研究中，也发现有其严格的时间依赖性。最适的时间给药方案，对于减少不良反应，增加药物最大安全强度，增强疗效方面的优越性，已为现代临床研究证实。一种适合于单药或多药联合使用，带有各药最适给药时间程序的轻便输药泵已用于临床。强调按最佳昼夜时刻给药的癌症时间化疗方案，正日益受到重视。Biologic rhythm belongs to basic features of life phenomena, it may produce circadian variation of drug metabolism and tissue sensitivity to chemotherapeutic agents. The view that toxicity may be reduced and anticancer effciency improved by timing administration of antineoplastic agents is increasingly received by its importance. Animal experiment and clinical data of time-dependency of drug effect are available for at least 20 anticancer agents. Anthracycline antibiotics (doxorubicin and THP-doxorubicin) seem to favor early morning administration. Reactive nucleophilic platinum-based drugs (cisplatin, oxaliplatin and carboplatin) are more safely and effectively administered in the evening. Antimetabolites (5-Fu, FUDR, Ara-C, 6-MP and MTX) are better tolerated and most effective when administered in the evening or early in the daily sleep time. The bioactivities of hormones, growth factors, and biologic response modifiers are more critical dependent on their circadian timing. Advantages of optimal circadian scheduling have been demonstrated by diminishing side effects and increasing maximal safe dose intensity of diverse class. The availability of portable infusion pumps capable of delivering single or mutiple drugs, each with their optimal circadian scheduling, has made the wider clinical application of these observations possible.

关 键 词：昼夜节律 抗癌药 时间 药物疗法 

分 类 号：R730.53[医药卫生—肿瘤]