Heyne K E, Lippman S M, Hong W K
Section of Head, Neck and Thoracic Medical Oncology, University of Texas, M.D. Anderson Cancer Center, Houston.
Hematol Oncol Clin North Am. 1991 Aug;5(4):783-95.
It is not a coincidence that the aerodigestive tract has proven such a fertile ground for the evaluation of chemoprevention. The incidence of second primaries and the concept of field cancerization made the need for prevention acute and showed the limitations of even the most curative of treatments. New and presumably less toxic agents are being evaluated; chemoprevention is being applied to asymptomatic populations at higher risk for lung, colon, breast, and other neoplasias. Biomarkers may be instrumental in rapid development of these new clinical applications, but much is still to be done. Yet unanswered is whether suppression of premalignant lesions will ultimately decrease cancer incidence. Survival in the second primary prevention trial has not thus far shown a significant improvement and toxicities were significant. Many questions remain in the study of chemoprevention; head and neck cancer provides a conducive model in which these answers might be found.
上呼吸道消化道已被证明是评估化学预防的沃土，这并非巧合。第二原发性肿瘤的发病率和场癌化的概念使预防的需求变得迫切，并显示出即使是最具治愈性的治疗方法也存在局限性。新的且毒性可能较小的药物正在接受评估；化学预防正在应用于肺癌、结肠癌、乳腺癌和其他肿瘤发生风险较高的无症状人群。生物标志物可能有助于这些新临床应用的快速发展，但仍有许多工作要做。然而，癌前病变的抑制最终是否会降低癌症发病率仍未得到解答。迄今为止，第二原发性预防试验中的生存率并未显示出显著改善，且毒性显著。化学预防研究中仍存在许多问题；头颈癌提供了一个有助于找到这些答案的模型。
