Department of Chronic Diseases, National Institute for Health Development, Paldiski mnt 80, 10617 Tallinn, Estonia.
2nd Surgery Department, General Surgery and Oncology Surgery Centre, North Estonia Medical Centre, J. Sütiste Str. 19, 13419 Tallinn, Estonia.
Curr Oncol. 2024 Apr 3;31(4):1994-2023. doi: 10.3390/curroncol31040149.
Melatonin is a multifunctional hormone regulator that maintains homeostasis through circadian rhythms, and desynchronization of these rhythms can lead to gastrointestinal disorders and increase the risk of cancer. Preliminary clinical studies have shown that exogenous melatonin alleviates the harmful effects of anticancer therapy and improves quality of life, but the results are still inconclusive due to the heterogeneity of the studies. A personalized approach to testing clinical parameters and response to integrative treatment with nontoxic and bioavailable melatonin in patient-centered N-of-1 studies deserves greater attention. This clinical case of colon cancer analyzes and discusses the tumor pathology, the adverse effects of chemotherapy, and the dynamics of markers of inflammation (NLR, LMR, and PLR ratios), tumors (CEA, CA 19-9, and PSA), and hemostasis (D-dimer and activated partial thromboplastin time). The patient took melatonin during and after chemotherapy, nutrients (zinc, selenium, vitamin D, green tea, and taxifolin), and aspirin after chemotherapy. The patient's PSA levels decreased during CT combined with melatonin (19 mg/day), and melatonin normalized inflammatory markers and alleviated symptoms of polyneuropathy but did not help with thrombocytopenia. The results are analyzed and discussed in the context of the literature on oncostatic and systemic effects, alleviating therapy-mediated adverse effects, association with survival, and N-of-1 studies.
褪黑素是一种多功能激素调节剂,通过昼夜节律维持体内平衡,这些节律的失同步可能导致胃肠道紊乱,并增加癌症风险。初步临床研究表明,外源性褪黑素减轻了抗癌治疗的有害影响,提高了生活质量,但由于研究的异质性,结果仍不确定。在以患者为中心的 N-of-1 研究中,针对临床参数进行个性化测试,并对整合治疗进行测试,采用非毒性和生物可利用的褪黑素,值得引起更多关注。本结肠癌临床病例分析和讨论了肿瘤病理学、化疗的不良反应以及炎症标志物(NLR、LMR 和 PLR 比值)、肿瘤标志物(CEA、CA19-9 和 PSA)和止血标志物(D-二聚体和活化部分凝血活酶时间)的动态变化。患者在化疗期间和之后服用褪黑素、营养物质(锌、硒、维生素 D、绿茶和taxifolin)和化疗后服用阿司匹林。在 CT 联合褪黑素(19 毫克/天)治疗期间,患者的 PSA 水平下降,褪黑素使炎症标志物正常化并缓解多发性神经病症状,但对血小板减少症没有帮助。结果根据关于肿瘤抑制和全身作用、缓解治疗介导的不良反应、与生存的关联以及 N-of-1 研究的文献进行了分析和讨论。
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