联合铂类的化疗方案在晚期食管癌中的临床评价及Polι对铂类化疗药物敏感性的影响  

Study of Clinical Evaluation of Platinum-based Chemotherapy in Patients with Advanced Esophageal Cancer and the Correlation Between Polι and Sensitivity of Platinum-based Chemotherapy

作　　者：高雯雯[1] 谭洁[1] 吴锦昌[1] 王彬[1] 何志洁[1] 张明[1] 

机构地区：[1]南京医科大学附属苏州医院,江苏苏州215001

出　　处：《肿瘤学杂志》2015年第2期151-156,共6页Journal of Chinese Oncology

摘　　要：近年来,食管癌的诊治水平日益提高,然而晚期食管癌患者中位生存期仍偏短,多药联合化疗是其最主要的治疗手段。本文综合大量临床前期和临床早期的试验数据表明,联合顺铂治疗晚期食管癌疗效较好。但第一代铂类顺铂出现原发及继发性肿瘤耐药,以及较重的化疗不良反应,故铂类金属抗肿瘤药物研究开发一直较为活跃,不断有新的顺铂类配合物被合成并应用于临床试验。本文描述了3代铂类抗肿瘤药物中的代表药物,以探究如何发挥铂类抗食管癌最大效果同时又把不良反应降到最低,需更深层次研究铂类耐药的机制,不仅是对铂类本身结构进行改造,更要深入到基因层次。目前一种参与DNA损伤修复的基因Polι受到了越来越多的关注,已有研究证实其参与了肿瘤的发生、发展以及化疗药物的耐药。其表达量高可能提示对顺铂反应性不佳,可作为食管癌生物学特征、预后判断以及是否可行顺铂化疗的参考指标。The diagnosis and treatment of esophageal cancer have increased greatly in recent years. However,the MST of patients with advanced esophageal cancer is relatively short,and multi-drug chemotherapy is main treatment regimen. In this paper,a large comprehensive preclinical data has illustrated that the efficacy of chemotherapy in combination with cisplatin is pretty good. As the first generation of platinum--cisplatin emerged primary and secondary tumorresistance,as well as serious side effects,continuous new cis-platinum complexes have been synthesized and used in clinical trials.This paper has described the representatives of the three generations of platinum-based anticancer drugs. How to exert the maximum effect of platinum and the side effects to a minimum simultaneously,that＇s what we should dedicated to. We need further move to study the mechanism of platinum-resistance, both to platinum itself, and also further step into genetic level. Currently a gene involved in DNA damage repair called Polo gains mbre and more attention, some studies have confirmed its participation in the tumor progression and the resistance to chemotherapeutic drugs. Its high expression level may indicate poor responsiveness to cisplatin, and it can be used as a biological characteristic, prognosis of esophageal cancer, and a reference index about the feasibility of eisplatin chemotherapy.

关 键 词：食管肿瘤 顺铂 Polι 

分 类 号：R735.1[医药卫生—肿瘤]