Lippman S M, Benner S E, Hong W K
Department of Medical Oncology, University of Texas, M.D. Anderson Cancer Center, Houston.
Chest. 1993 Jan;103(1 Suppl):15S-19S. doi: 10.1378/chest.103.1_supplement.15s.
Chemoprevention entails using specific agents to suppress carcinogenesis and thereby prevent the development of primary or second primary cancers. Because the concept of chemoprevention in patients with or at risk of lung cancer is new, ongoing clinical trials are based on data from epidemiologic and preclinical research, as well as on results of chemoprevention studies in head and neck cancer. The latter studies have provided a model for such studies in lung cancer, considering the two diseases have a similar etiology and biology of field carcinogenesis. Beta-carotene, natural vitamin A, and the retinoids may be effective chemopreventive agents. However, chronic administration of such agents may be required to prevent the development of cancer. Results of chemoprevention trials in head and neck cancer have demonstrated effective inhibition of the development of second primary tumors with the synthetic retinoid 13-cis-retinoic acid; investigators are hopeful this will be repeated in patients with lung cancer. Results of ongoing phase III trials and continued advances in the epidemiologic and biologic study of lung carcinogenesis should contribute to future research in this area.
化学预防是指使用特定药物抑制致癌作用，从而预防原发性或第二原发性癌症的发生。由于肺癌患者或肺癌高危人群的化学预防概念尚新，目前正在进行的临床试验基于流行病学和临床前研究数据，以及头颈癌化学预防研究的结果。考虑到这两种疾病具有相似的病因和场致癌生物学特性，后者的研究为肺癌的此类研究提供了一个模型。β-胡萝卜素、天然维生素A和类视黄醇可能是有效的化学预防药物。然而，可能需要长期服用此类药物以预防癌症的发生。头颈癌化学预防试验的结果表明，合成类视黄醇13-顺式维甲酸可有效抑制第二原发性肿瘤的发生；研究人员希望这一结果能在肺癌患者中得到重现。正在进行的III期试验结果以及肺癌致癌作用流行病学和生物学研究的持续进展应有助于该领域的未来研究。
