Ayllón Barbellido Sonia, Campo Trapero Julián, Cano Sánchez Jorge, Perea García Miguel A, Escudero Castaño Nayra, Bascones Martínez Antonio
Facultad de Odontología, UCM, Madrid, Spain.
Med Oral Patol Oral Cir Bucal. 2008 Jan 1;13(1):E15-21.
Gene therapy essentially consists of introducing specific genetic material into target cells without producing toxic effects on surrounding tissue. Advances over recent decades in the surgical, radiotherapeutic and chemotherapeutic treatment of oral cancer patients have not produced a significant improvement in patient survival. Increasing interest is being shown in developing novel therapies to reverse oral epithelial dysplastic lesions. This review provides an update on transfer techniques, therapeutic strategies, and the clinical applications and limitations of gene therapy in the management of oral cancer and precancer. We highlight the combination of gene therapy with chemotherapy (e.g., 5-Fluoracil) and immunotherapy, given the promising results obtained in the use of adenovirus to act at altered gene level (e.g., p53). Other techniques such as suicide gene therapy, use of oncolytic viruses or the use of antisense RNA have shown positive although very preliminary results. Therefore, further research into these promising gene therapy techniques is required to assess their true efficacy and safety in the management of these lesions.
基因治疗本质上是将特定的遗传物质导入靶细胞,而不对周围组织产生毒性作用。近几十年来,口腔癌患者的手术、放射治疗和化学治疗虽有进展,但患者生存率并未显著提高。人们对开发逆转口腔上皮发育异常病变的新疗法越来越感兴趣。本综述提供了基因治疗在口腔癌和癌前病变管理中的转移技术、治疗策略、临床应用及局限性的最新情况。鉴于使用腺病毒在改变的基因水平(如p53)发挥作用取得了有前景的结果,我们强调了基因治疗与化疗(如5-氟尿嘧啶)和免疫治疗的联合应用。其他技术如自杀基因治疗、溶瘤病毒的使用或反义RNA的使用虽显示出积极但非常初步的结果。因此,需要对这些有前景的基因治疗技术进行进一步研究,以评估它们在这些病变管理中的真正疗效和安全性。