Xuan Wei, Hankin James, Zhao Hailin, Yao Shanglong, Ma Daqing
Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom.
Int J Cancer. 2015 Dec 15;137(12):2774-84. doi: 10.1002/ijc.29306. Epub 2014 Nov 10.
Cancer is a leading cause of morbidity and mortality worldwide. In light of demographic changes among other factors, it is anticipated this trend will continue. Surgical resection is the primary method of treating solid tumours. Unfortunately, even with the use of adjunct therapies, metastatic disease is a leading cause of death in people with cancer. Recent evidence suggests choice of anesthetic technique may influence cancer outcome. This review considers the latest evidence regarding local and regional anesthesia in the context of cancer biology. There is a focus on the indirect and direct mechanisms involved. An integrated approach is used such that diverse areas of research are explored; ranging from epigenetics to cell death pathways. With a better understanding of how regional anesthesia and/or local anesthetics interact with cancer cells, these techniques can be trialed and evaluated to ascertain potential clinical benefits in cancer patients. Thus far, there is insufficient evidence to warrant a change in clinical practice.
癌症是全球发病和死亡的主要原因。鉴于人口结构变化等因素，预计这一趋势将持续。手术切除是治疗实体瘤的主要方法。不幸的是，即使使用辅助治疗，转移性疾病仍是癌症患者死亡的主要原因。最近的证据表明，麻醉技术的选择可能会影响癌症的治疗结果。本综述考虑了癌症生物学背景下关于局部和区域麻醉的最新证据。重点关注其中涉及的间接和直接机制。采用综合方法，探索从表观遗传学到细胞死亡途径等不同研究领域。通过更好地理解区域麻醉和/或局部麻醉剂如何与癌细胞相互作用，可以对这些技术进行试验和评估，以确定对癌症患者的潜在临床益处。到目前为止，尚无足够证据支持改变临床实践。
