Salim A S
University Department of Surgery, Medical City, Baghdad, Iraq.
Chemotherapy. 1992;38(2):135-44. doi: 10.1159/000238953.
The influence of oxygen-derived free radical scavengers on survival in gastric cancer, with serosal invasion and metastases to the lymph nodes surrounding the stomach, was assessed in a prospective randomized controlled double-blind trial conducted for 5 years. To this end, allopurinol (inhibits the enzyme xanthine oxidase which is responsible for the formation of superoxide radicals and scavengers hydroxyl radicals) and dimethyl sulphoxide (DMSO; scavengers hydroxyl radicals) were used. Following potentially curative distal two-thirds partial gastrectomy, 228 patients making an uneventful recovery from surgery were randomized to the control group or to receive allopurinol (50 mg by mouth 4 times a day) or DMSO (500 mg by mouth 4 times a day). In 160 fully evaluable patients who were studied for 5 years, allopurinol and DMSO incurred a significant (p less than 0.01) survival advantage over the whole period of study. The similarity in efficacy between allopurinol and DMSO and the fact that the only action they share is scavenging oxyradicals suggest that these radicals mediate the aggressiveness of gastric cancer by producing tissue damage, thus allowing the cancer to spread. Consequently, oxygen-derived free radicals are implicated in the mechanism of gastric cancer, and removing them provides patients with a survival advantage.
在一项为期5年的前瞻性随机对照双盲试验中，评估了氧衍生自由基清除剂对伴有浆膜侵犯和胃周围淋巴结转移的胃癌患者生存率的影响。为此，使用了别嘌醇（抑制负责超氧自由基形成的黄嘌呤氧化酶并清除羟自由基）和二甲基亚砜（DMSO；清除羟自由基）。在进行了潜在根治性的远端胃大部切除术后，228例术后恢复顺利的患者被随机分为对照组，或接受别嘌醇（每日4次，每次口服50 mg）或DMSO（每日4次，每次口服500 mg）。在160例接受了5年研究的可全面评估的患者中，在整个研究期间，别嘌醇和DMSO均具有显著的（p<0.01）生存优势。别嘌醇和DMSO在疗效上的相似性以及它们唯一的共同作用是清除氧自由基这一事实表明，这些自由基通过造成组织损伤来介导胃癌的侵袭性，从而使癌症得以扩散。因此，氧衍生自由基与胃癌的发病机制有关，清除它们可为患者带来生存优势。
