Hoogsteen I J, Marres H A M, van der Kogel A J, Kaanders J H A M
Department of Radiation Oncology, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands.
Clin Oncol (R Coll Radiol). 2007 Aug;19(6):385-96. doi: 10.1016/j.clon.2007.03.001. Epub 2007 Apr 12.
Tumour hypoxia has been found to be a characteristic feature in many solid tumours. It has been shown to decrease the therapeutic efficacy of radiation treatment, surgery and some forms of chemotherapy. Successful approaches have been developed to counteract this resistance mechanism, although usually at the cost of increased short- and long-term side-effects. New methods for qualitative and quantitative assessment of tumour oxygenation have made it possible to establish the prognostic significance of tumour hypoxia. The ability to determine the degree and extent of hypoxia in solid tumours is not only important prognostically, but also in the selection of patients for hypoxia-modifying treatments. To provide the best attainable quality of life for individual patients it is of increasing importance that tools be developed that allow a better selection of patients for these intensified treatment strategies. Several genes and proteins involved in the response to hypoxia have been identified as potential candidates for future use in predictive assays. Although some markers and combinations have shown potential benefit and are associated with treatment outcome, their clinical usefulness needs to be validated in prospective trials. A review of published studies was carried out, focusing on the assessment of tumour hypoxia, patient selection and the possibilities to overcome hypoxia during treatment.
肿瘤缺氧已被发现是许多实体瘤的一个特征性表现。研究表明，它会降低放射治疗、手术及某些化疗方式的治疗效果。尽管通常会以增加短期和长期副作用为代价，但已开发出成功的方法来对抗这种耐药机制。肿瘤氧合定性和定量评估的新方法使得确定肿瘤缺氧的预后意义成为可能。确定实体瘤缺氧程度和范围的能力不仅在预后方面很重要，而且在选择接受缺氧改善治疗的患者时也很重要。为了给个体患者提供最佳的生活质量，开发能够更好地选择患者进行这些强化治疗策略的工具变得越来越重要。几种参与缺氧反应的基因和蛋白质已被确定为未来用于预测分析的潜在候选物。尽管一些标志物及其组合已显示出潜在益处并与治疗结果相关，但其临床实用性仍需在前瞻性试验中得到验证。本文对已发表的研究进行了综述，重点关注肿瘤缺氧的评估、患者选择以及治疗期间克服缺氧的可能性。
