Ishikawa Hideki
Laboratory of Hereditary Tumor, Institute for Advanced Medical Sciences, Hyogo College of Medicine, 2-3-1-2F Kyomachibori, Nishi-ku, 550-0003, Osaka, Japan.
Int J Clin Oncol. 2004 Aug;9(4):299-303. doi: 10.1007/s10147-004-0417-1.
Among familial cancers, chemoprevention has been studied for familial adenomatous polyposis, hereditary nonpolyposis colorectal cancers, and familial breast cancers. This report reviews the studies on chemoprevention in familial adenomatous polyposis. A large number of clinical trials have been performed using sulindac, a non-steroidal anti-inflammatory drug (NSAID). Sulindac reduces the size and number of large-bowel polyps. However, as yet, it cannot be used for this indication in the clinical setting, because of the frequent occurrence of serious gastrointestinal side effects, and there are a number of patients in whom aggressive tumors developed despite a reduction in the size of polyps. Studies of cyclooxygenase-2 (COX-2) selective inhibitors, with minimal side effects on the digestive tract, are showing promising results. In addition to NSAIDs, clinical trials have been performed using vitamins and dietary components. These show minimal side effects, but their efficacy is still insufficient for clinical use, and further studies are anticipated.
在家族性癌症中，已经对家族性腺瘤性息肉病、遗传性非息肉病性结直肠癌和家族性乳腺癌进行了化学预防研究。本报告回顾了家族性腺瘤性息肉病化学预防的研究情况。已经使用非甾体抗炎药（NSAID）舒林酸进行了大量临床试验。舒林酸可减小大肠息肉的大小并减少其数量。然而，由于严重胃肠道副作用频繁发生，目前它还不能在临床环境中用于此适应症，而且有许多患者尽管息肉大小有所减小，但仍出现侵袭性肿瘤。对消化道副作用极小的环氧合酶-2（COX-2）选择性抑制剂的研究显示出有前景的结果。除了NSAIDs之外，还使用维生素和膳食成分进行了临床试验。这些显示出极小的副作用，但其疗效仍不足以用于临床，预计还需要进一步研究。
