Das Bibhu R, Nagpal Jatin K
Molecular Oncology and Medical Biotechnology Division, Institute of Life Sciences, Chandrasekharpur, Bhubaneswar, India.
Med Sci Monit. 2002 Nov;8(11):RA258-67.
The present review is an attempt to summarize the important advances made during the last decade in the molecular approach to oral cancer and its application for early, sensitive diagnosis, effective treatment, and improved prognosis. Cancer of the oral cavity is more prevalent in developing countries, where many people are addicted to tobacco chewing and maintain poor oral hygiene. Despite extensive research on the biological and molecular aspects of oral SCC, the problems of local-regional recurrence and distant metastasis still persist. Among the more pressing problems in clinical management is the lack of early detection, due to the absence of a potential diagnostic marker. Oncologists are now more aware of the challenges associated with the treatment of cancer of the oral cavity, and survival percentages are improving significantly. More trials are need in the area of improved surgical procedures, variations in dosages of radiotherapy, and the use of various combinations of chemotherapeutic agents with minimal side effects. Moreover, progress in the elucidation of the molecular genetic changes that lead to the development of these tumors should soon bring novel diagnostic and therapeutic procedures into clinical practice. The case of ONYX-015 is one example of success, which has shown the great potential in Phase-I and II clinical trials. Finally, the legislator should also impose some restrictions and bans on the easy availability of various forms of tobacco.
本综述旨在总结过去十年间在口腔癌分子研究方法方面取得的重要进展,以及该方法在早期、灵敏诊断、有效治疗和改善预后方面的应用。口腔癌在发展中国家更为普遍,那里许多人有嚼烟草的习惯且口腔卫生状况较差。尽管对口腔鳞状细胞癌的生物学和分子方面进行了广泛研究,但局部区域复发和远处转移问题仍然存在。临床管理中更紧迫的问题之一是由于缺乏潜在的诊断标志物而导致早期检测不足。肿瘤学家现在更加意识到与口腔癌治疗相关的挑战,并且生存率正在显著提高。在改进手术程序、放疗剂量变化以及使用副作用最小的各种化疗药物组合方面需要更多试验。此外,在阐明导致这些肿瘤发生的分子遗传变化方面取得的进展,应该很快会将新的诊断和治疗程序引入临床实践。ONYX - 015的情况就是成功的一个例子,它在I期和II期临床试验中显示出了巨大潜力。最后,立法者也应对各种形式烟草的轻易可得性施加一些限制和禁令。