Academic Unit of Surgery, School of Medicine - University of Glasgow, Royal Infirmary, Glasgow G31 2ER, UK.
Br J Cancer. 2014 Mar 18;110(6):1409-12. doi: 10.1038/bjc.2014.90. Epub 2014 Feb 18.
Determinants of cancer progression and survival are multifactorial and host responses are increasingly appreciated to have a major role. Indeed, the development and maintenance of a systemic inflammatory response has been consistently observed to confer poorer outcome, in both early and advanced stage disease. For patients, cancer-associated symptoms are of particular importance resulting in a marked impact on day-to-day quality of life and are also associated with poorer outcome. These symptoms are now recognised to cluster with one another with anorexia, weight loss and physical function forming a recognised cluster whereas fatigue, pain and depression forming another. Importantly, it has become apparent that these symptom clusters are associated with presence of a systemic inflammatory response in the patient with cancer. Given the understanding of the above, there is now a need to intervene to moderate systemic inflammatory responses, where present. In this context the rationale for therapeutic intervention using nonselective anti-inflammatory agents is clear and compelling and likely to become a part of routine clinical practice in the near future. The published literature on therapeutic intervention using anti-inflammatory agents for cancer-associated symptoms was reviewed. There are important parallels with the development of useful treatments for the systemic inflammatory response in patients with rheumatological disease and cardiovascular disease.
癌症进展和生存的决定因素是多因素的，宿主反应越来越被认为起着重要作用。事实上，在早期和晚期疾病中，系统炎症反应的发展和维持一直被观察到会导致更差的结果。对于患者来说，与癌症相关的症状尤其重要，导致日常生活质量显著下降，并且与更差的结果相关。这些症状现在被认为彼此相关，厌食、体重减轻和身体功能形成一个公认的集群，而疲劳、疼痛和抑郁则形成另一个集群。重要的是，现在已经明显的是，这些症状集群与癌症患者存在系统性炎症反应有关。鉴于对上述情况的了解，现在需要进行干预以调节存在的系统性炎症反应。在这种情况下，使用非选择性抗炎药物进行治疗干预的理由是明确的和令人信服的，并且可能在不久的将来成为常规临床实践的一部分。对使用抗炎药物治疗与癌症相关症状的治疗干预的文献进行了回顾。在为风湿性疾病和心血管疾病患者的系统性炎症反应开发有用的治疗方法方面，有重要的相似之处。
