Muthusamy Prema, Chary Krishnan Vengadaragava, Nalini G K
Postgraduate, Department of Pharmacology, Haasan Institute of Medical Sciences , Haasan, Karanataka, India .
Assistant Professor, Department of Pharmacology, Saveetha Medical College , Chennai, Tamil Nadu, India .
J Clin Diagn Res. 2016 Nov;10(11):FC09-FC13. doi: 10.7860/JCDR/2016/23782.8802. Epub 2016 Nov 1.
Metronomic chemotherapy is an emerging method of chemotherapy. Metronomic 'lowdose' chemotherapy regimen induces tumour dormancy and reduces cancer resistance against anticancer drugs. It tends to improve overall success rate of cancer chemotherapy than conventional cyclical regimen.
The aim of this systemic review was to provide comprehensive data of metronomic chemotherapy trials, regimens used and it's outcome in cancer therapeutics.
Fifty chemotherapy trial data were searched sequentially from web. The main sources were official website of Clinical trial forum, USA and Clinical Trial Registry India (CTRI). Evidence on efficacy and safety of such metronomic chemotherapy trials was gathered from various data published in Medline, New England Journal of Medicine (NEJM), Lancet Oncology and other journals with high credentials. As a result of our search, out of 50 trials including breast -15(30%), colon-, 5(10%) ovarian -5(10%), prostate-5(10%) and others including haematologic, soft tissue and nervous system malignancies -20 (50%). Twenty seven trials showed favourable, 20 trials showed equivocal outcome and 3 trials reported unfavourable outcome. Overall comparison showed definitive statistical significance for using metronomic regimen (p-0.05).
It can be concluded that metronomic chemotherapy regimen seems convincing beneficial to induce tumour remission and survival at a higher than conventional regimen. More metanalyses are needed to frame common metronomic chemotherapeutic regimen.
节拍化疗是一种新兴的化疗方法。节拍“低剂量”化疗方案可诱导肿瘤休眠,并降低癌症对抗癌药物的耐药性。与传统的周期性化疗方案相比,它往往能提高癌症化疗的总体成功率。
本系统评价的目的是提供节拍化疗试验的全面数据、所使用的方案及其在癌症治疗中的结果。
从网上依次检索了50项化疗试验数据。主要来源是美国临床试验论坛的官方网站和印度临床试验注册中心(CTRI)。此类节拍化疗试验的疗效和安全性证据来自发表在《医学索引》、《新英格兰医学杂志》(NEJM)、《柳叶刀肿瘤学》和其他高可信度期刊上的各种数据。在我们检索的50项试验中,乳腺癌试验15项(30%),结肠癌试验5项(10%),卵巢癌试验5项(10%),前列腺癌试验5项(10%),其他包括血液系统、软组织和神经系统恶性肿瘤试验20项(50%)。27项试验显示出良好效果,20项试验结果不明确,3项试验报告了不良结果。总体比较显示使用节拍化疗方案具有显著统计学意义(p = 0.05)。
可以得出结论,节拍化疗方案似乎在诱导肿瘤缓解和提高生存率方面比传统方案更具说服力,益处更大。需要更多的荟萃分析来制定通用的节拍化疗方案。