Messina Giuseppina, Lissoni Paolo, Marchiori Paolo, Bartolacelli Erio, Brivio Fernando, Magotti Luciano
Psychological Service, Fondazione IRCCS, Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
J Res Med Sci. 2010 Jul;15(4):225-8.
The anti-oxidant and immunomodulating natural agents may enhance the efficacy of cancer chemotherapy. One of the most important agents is the pineal hormone melatonin (MLT) which may exert both anti-oxidant and antiproliferative immunostimulating anticancer effects. This study was performed to evaluate the efficacy of a biochemotherapeutic regimen in metastatic cancer patients, and its therapeutic activity in relation to the psychospiritual status of patients.
The study included 50 metastatic non-small cell lung cancer (NSCLC) patients and a control group of 100 patients. Chemotherapy consisted of cisplatin plus gemcitabine. MLT was given orally at 20 mg/day in the evening. Patients were subdivided into 5 psychic profiles, as follows: spiritual faith, rationale faith, anxiety, apathy, and accusation behavior.
Tumor response rate was significantly higher in patients treated by chemotherapy plus MLT than in those treated by chemotherapy alone (21/50 vs. 24/100, p < 0.001). However, the percentage of objective tumor regressions obtained in patients with spiritual faith was significantly higher than that found in the overall other patients concomitantly treated by chemotherapy plus MLT (6/8 vs. 15/42, p < 0.01).
In conclusion, the efficacy of chemotherapy may be enhanced by the pineal hormone MLT, by representing a new promising biochemotherapeutic combination; also despite its objective ability to enhance chemotherapy efficacy, the activity of MLT is depending at least in part on the psychospiritual status of cancer patients, and it is maximal in the presence of a real spiritual faith.
抗氧化和免疫调节天然制剂可能会增强癌症化疗的疗效。其中最重要的制剂之一是松果体激素褪黑素（MLT），它可能具有抗氧化和抗增殖免疫刺激抗癌作用。本研究旨在评估一种生物化疗方案对转移性癌症患者的疗效，以及其与患者心理精神状态相关的治疗活性。
该研究纳入了50例转移性非小细胞肺癌（NSCLC）患者和一个由100例患者组成的对照组。化疗方案为顺铂加吉西他滨。MLT于每晚口服，剂量为20mg/天。患者被分为5种心理类型，如下：精神信仰型、理性信仰型、焦虑型、冷漠型和指责行为型。
化疗联合MLT治疗的患者肿瘤反应率显著高于单纯化疗的患者（21/50 vs. 24/100，p < 0.001）。然而，精神信仰型患者的客观肿瘤消退百分比显著高于其他同时接受化疗联合MLT治疗的患者（6/8 vs. 15/42，p < 0.01）。
总之，松果体激素MLT可能会增强化疗疗效，代表一种新的有前景的生物化疗组合；尽管MLT客观上有增强化疗疗效的能力，但其活性至少部分取决于癌症患者的心理精神状态，在存在真正精神信仰的情况下活性最大。
