Simsek Cem, Esin Ece, Yalcin Suayib
Department of Internal Medicine, Hacettepe University, Ankara, Turkey.
Department of Medical Oncology, A.Y. Ankara Training Hospital, Ankara, Turkey.
J Oncol. 2019 Mar 20;2019:5483791. doi: 10.1155/2019/5483791. eCollection 2019.
Metronomic chemotherapy, continuous and dose-dense administration of chemotherapeutic drugs with lowered doses, is being evaluated for substituting, augmenting, or appending conventional maximum tolerated dose regimens, with preclinical and clinical studies for the past few decades. To date, the principle mechanisms of its action include impeding tumoral angiogenesis and modulation of hosts' immune system, affecting directly tumor cells, their progenitors, and neighboring stromal cells. Its better toxicity profile, lower cost, and easier use are main advantages over conventional therapies. The evidence of metronomic chemotherapy for personalized medicine is growing, starting with unfit elderly patients and also for palliative treatment. The literature reviewed in this article mainly demonstrates that metronomic chemotherapy is advantageous for selected patients and for certain types of malignancies, which make it a promising therapeutic approach for filling in the gaps. More clinical studies are needed to establish a solidified role for metronomic chemotherapy with other treatment models in modern cancer management.
节拍化疗,即持续且剂量密集地给予低剂量化疗药物,在过去几十年中一直通过临床前和临床研究进行评估,以替代、增强或附加传统的最大耐受剂量方案。迄今为止,其主要作用机制包括阻碍肿瘤血管生成和调节宿主免疫系统,直接影响肿瘤细胞、其祖细胞和邻近的基质细胞。与传统疗法相比,其更好的毒性特征、更低的成本和更易使用是主要优势。节拍化疗用于个性化医疗的证据越来越多,首先是针对不适合接受常规治疗的老年患者,也用于姑息治疗。本文综述的文献主要表明,节拍化疗对特定患者和某些类型的恶性肿瘤具有优势,这使其成为一种有前景的治疗方法,可填补空白。需要更多的临床研究来确立节拍化疗在现代癌症管理中与其他治疗模式相结合的稳固作用。