Goodnight J E, Morton D L
Int Adv Surg Oncol. 1978;1:53-83.
Because systemic spread occurs early in the growth of many malignancies, control of occult micrometastases must be an integral part of cancer treatment. For this reason, surgery and radiation therapy alone may fail to achieve a cure despite eradication of the primary tumor. Chemotherapy is potent and systemic in its effects but kills tumor cells by first-order kinetics so the last cancer cell may not be eliminated. An agent is needed that can selectively attack and destroy small numbers of tumor cells on a systemic basis without a significant increase in toxicity. Experimental observations indicate that immunotherapy could fill this role. Immunotherapy has been tested as an adjuvant to surgery, radiation therapy, and chemotherapy, and is clearly beneficial for selected cancer patients. There are many unresolved questions regarding the underlying mechanisms as well as the practical application of adjuvant immunotherapy, but the initial investigations indicate that it could play a vital part in the treatment of cancer. There is evidence that stimulation of host resistance can result in control of systemic micrometastases.
由于在许多恶性肿瘤生长的早期就会发生全身扩散，因此控制隐匿性微转移必须成为癌症治疗的一个组成部分。出于这个原因，尽管原发性肿瘤已被根除，但仅手术和放射治疗可能无法实现治愈。化疗效果强大且具有全身性，但通过一级动力学杀死肿瘤细胞，所以最后一个癌细胞可能无法被清除。需要一种能够在全身基础上选择性攻击和摧毁少量肿瘤细胞而又不会显著增加毒性的药物。实验观察表明免疫疗法可以发挥这一作用。免疫疗法已作为手术、放射治疗和化疗的辅助手段进行了测试，并且对特定的癌症患者显然有益。关于辅助免疫疗法的潜在机制以及实际应用，仍有许多未解决的问题，但初步研究表明它可能在癌症治疗中发挥至关重要的作用。有证据表明，刺激宿主抵抗力可导致对全身微转移的控制。
