Urushizaki I
Sapporo Medical College, East Sapporo Hospital.
Gan To Kagaku Ryoho. 1990 Oct;17(10):2119-29.
Almost all of anti-cancer drugs developed, injured not only the tumor cells but also the normal cells. For this reason, immunotherapy which injures specifically the tumor cells, has been developed. However, the clinical studies conducted in the past 20 years tend to indicate that even though the immunotherapy does not produce any serious side effect, the anti-tumor effect are not totally satisfactory in spite of marked prolongation of survivals. In recent years, various fields of cancer therapy have seen the development and application of treatment modalities which take into account the quality of the patients. Several patient's self-assessment questionnaires are widely used practical at the aims to assess what happens in the cancer-patients and to improve the cancer treatment. The measurements of quality of life have been performed on both immunochemotherapy group and chemotherapy group. The results showed the remarkable improvement of QOL in the immunochemotherapy group. The biotechnological advances have been made in the last 10 years. Various cytokines which participate in the immunological response between cancer and host. Many of these biologicals that will be called as biological response modifiers (BRM) are cell products of lymphocytes or macrophage. Systemic administration of exogenous cytokines to act against a tumor at a distant site may not be as successful as more localized therapy in situation. In most circumstances, cytokines are produced transiently at a local site acting in an autocrine or paracrine manner. Cytokines, whether naturally produced, or administered therapeutically, are rapidly clear from the circulation, both as a result of finding to often ubiquitous cell surface receptors, and by active excretion. So, the local injections of TNF and LAK cells are effective to decrease tumor size without the side effects. Finally, the serum level of IL-2 and TNF-alpha were determined for 24 healthy volunteers and 42 patients with advanced or terminal cancer, and the relationship between these levels and the QOL was investigated. In the cancer-patients who showed a higher serum level of IL-2 than the healthy volunteers, it was elucidated that there was an inverse correlation between the serum IL-2 level and the QOL. This finding cannot be explained at present, but it is surmised that, for this subpopulation of cancer-patients, the serum IL-2 level can probably serve as an objective biochemical index for use in evaluating the QOL.
几乎所有已研发出的抗癌药物不仅会损伤肿瘤细胞，也会损伤正常细胞。因此，专门损伤肿瘤细胞的免疫疗法得以发展。然而，过去20年进行的临床研究倾向于表明，尽管免疫疗法不会产生任何严重的副作用，但尽管生存期显著延长，其抗肿瘤效果仍不尽人意。近年来，癌症治疗的各个领域都出现了考虑患者生活质量的治疗方式的发展和应用。几种患者自我评估问卷在实际中被广泛使用，目的是评估癌症患者的情况并改善癌症治疗。对免疫化疗组和化疗组都进行了生活质量的测量。结果显示免疫化疗组的生活质量有显著改善。在过去10年里生物技术取得了进展。各种细胞因子参与癌症与宿主之间的免疫反应。许多这类将被称为生物反应调节剂（BRM）的物质是淋巴细胞或巨噬细胞的细胞产物。在某些情况下，全身性给予外源性细胞因子以对抗远处的肿瘤可能不如更局部的治疗成功。在大多数情况下，细胞因子在局部以自分泌或旁分泌方式短暂产生。细胞因子，无论是天然产生的还是治疗性给予的，由于与普遍存在的细胞表面受体结合以及主动排泄，都会迅速从循环中清除。所以，局部注射肿瘤坏死因子（TNF）和淋巴因子激活的杀伤细胞（LAK细胞）在减少肿瘤大小方面有效且无副作用。最后，测定了24名健康志愿者和42名晚期或终末期癌症患者的白细胞介素-2（IL-2）和肿瘤坏死因子-α（TNF-α）的血清水平，并研究了这些水平与生活质量之间的关系。在血清IL-2水平高于健康志愿者的癌症患者中，发现血清IL-2水平与生活质量呈负相关。这一发现目前尚无法解释，但据推测，对于这一亚组的癌症患者，血清IL-2水平可能可作为评估生活质量的客观生化指标。
