Benner S E, Lippman S M, Hong W K
Section of Head, Neck, and Thoracic Medical Oncology, University of Texas, M.D. Anderson Cancer Center, Houston.
Oncology (Williston Park). 1992 Aug;6(8):61-6; discussion 66-8, 71 passim.
Chemoprevention involves efforts to block or reverse carcinogenesis before the development of invasive cancer. Natural agents, such as retinol and beta carotene, as well as synthetic retinoids have been studied as potential chemopreventive agents. In the head and neck, chemoprevention studies have included efforts both to reverse premalignant lesions such as oral leukoplakia and to prevent the development of second primary tumors. In one recent trial, high-dose 13-cis-retinoic acid treatment resulted in a dramatic reduction in the incidence of second primary tumors. However, significant toxicities were associated with the high dosage. This trial, as well as previous studies of oral leukoplakia, have led to the development of a chemoprevention trial using a low dose of 13-cis-retinoic acid to prevent second primary tumors following head and neck cancer. The rationale and design of this study are discussed in detail.
化学预防旨在在浸润性癌症发生之前阻止或逆转致癌过程。天然物质，如视黄醇和β-胡萝卜素，以及合成类视黄醇已作为潜在的化学预防剂进行了研究。在头颈部，化学预防研究既包括逆转癌前病变（如口腔白斑）的努力，也包括预防第二原发性肿瘤发生的努力。在最近的一项试验中，高剂量13-顺式维甲酸治疗使第二原发性肿瘤的发病率显著降低。然而，高剂量与显著的毒性相关。该试验以及先前关于口腔白斑的研究，促使开展了一项使用低剂量13-顺式维甲酸预防头颈部癌后第二原发性肿瘤的化学预防试验。本文详细讨论了该研究的基本原理和设计。
