Ludwig C U
Onkologische Abteilung, Departement für Innere Medizin, Kantonsspital, Basel.
Schweiz Med Wochenschr. 1990 Aug 7;120(31-32):1143-8.
Clearcut progress has been achieved in the treatment of lung cancer in the last decade. While small cell lung cancer has proven a highly chemosensitive tumor, only remissions of relatively short duration are obtained. The high relapse rate is probably due to the reappearance of chemoresistant subclones. In contrast, non small cell lung cancer is often chemoresistant from the outset, a fact which limits the therapeutic possibilities in these tumors. Different forms of chemoresistance are described and potential modalities of circumventing or reversing it are discussed. In recent years, greater insight into molecular mechanisms of tumor formation has been achieved. The role of activation or overexpression of oncogenes has been demonstrated. More recently the role of tumor suppressor gene inactivation has become evident. By means of restriction fragment length polymorphism (RFLP) a combination of gene deletions in various chromosomes has been demonstrated in lung cancer. The pattern of chromosomes involved appears to vary between small cell and non small cell lung cancer. It is to be hoped that these new insights will be translated into new treatment modalities for lung cancer.
在过去十年中,肺癌治疗已取得显著进展。虽然小细胞肺癌已被证明是一种对化疗高度敏感的肿瘤,但仅能获得相对较短时间的缓解。高复发率可能是由于化疗耐药亚克隆的再次出现。相比之下,非小细胞肺癌通常从一开始就对化疗耐药,这一事实限制了这些肿瘤的治疗可能性。本文描述了不同形式的化疗耐药,并讨论了规避或逆转它的潜在方式。近年来,人们对肿瘤形成的分子机制有了更深入的了解。已经证明了癌基因激活或过表达的作用。最近,肿瘤抑制基因失活的作用也变得明显。通过限制性片段长度多态性(RFLP),已在肺癌中证实了各种染色体上基因缺失的组合。涉及的染色体模式在小细胞肺癌和非小细胞肺癌之间似乎有所不同。希望这些新的见解能够转化为肺癌的新治疗模式。