Gaspar T B, Henriques J, Marconato L, Queiroga F L
Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.
Hospital Veterinário Berna, Lisboa, Portugal.
Vet Comp Oncol. 2018 Mar;16(1):2-11. doi: 10.1111/vco.12309. Epub 2017 Mar 20.
The era of chemotherapy, which started in the middle of the last century, has been ruled by the routine use of dose-intense protocols, based on the "maximum-tolerated dose" concept. By promoting a balance between patient's quality of life and the goal of rapidly killing as many tumour cells as possible, these protocols still play a prominent role in veterinary oncology. However, with the opening of a new millennium, metronomic chemotherapy (MC) started to be considered a possible alternative to traditional dose-intense chemotherapy. Characterized by a long-term daily administration of lower doses of cytotoxic drugs, this new modality stands out for its unique combination of effects, namely on neovascularization, immune response and tumour dormancy. This article reviews the rationale for treatment with MC, its mechanism of action and the main studies conducted in veterinary medicine, and discusses the key challenges yet to be solved.
从上世纪中叶开始的化疗时代，一直由基于“最大耐受剂量”概念的高剂量方案的常规使用所主导。通过在患者生活质量与尽可能快速杀死大量肿瘤细胞的目标之间取得平衡，这些方案在兽医肿瘤学中仍发挥着重要作用。然而，随着新千年的开启，节拍化疗（MC）开始被视为传统高剂量化疗的一种可能替代方案。这种新方法的特点是长期每日给予低剂量的细胞毒性药物，因其独特的综合效应而脱颖而出，即对肿瘤血管生成、免疫反应和肿瘤休眠的影响。本文综述了节拍化疗的治疗原理、作用机制以及在兽医学中开展的主要研究，并讨论了有待解决的关键挑战。
