Laerum O D, Smaaland R, Abrahamsen J F
Gade Institute, Department of Pathology, University of Bergen, Norway.
J Infus Chemother. 1995;5(3 Suppl 1):159-70.
In this article, a survey on the concepts and scientific basis for applying chemotherapy against malignant tumors on a circadian schedule is given. The idea is to give the cytostatic drugs at times of the day when optimal effect on the tumor is achieved, but at the same time causing minimal toxic side effects. Following a brief description of the complexity of cancer tissue, some aspects of the present status of cancer chemotherapy in general are reviewed. Applications of chronobiology in cancer treatment are then surveyed together with possibilities to increase cytostatic doses and reduce side effects. When optimal tumor cell kill is achieved, the next step is to address the circadian aspects of normal organs, including the proliferative behavior of tissues with rapid cell renewal. Finally, the question of how regulatory mechanisms responsible for normal circadian rhythms can be interfered with is addressed. Cancer chronochemotherapy today combined with modern infusional technology is a promising field for improving cancer treatment in general and reducing side effects and is expected to make important progress in the near future.
本文对按昼夜节律应用化疗治疗恶性肿瘤的概念和科学依据进行了综述。其理念是在一天中对肿瘤产生最佳疗效的时间给予细胞毒性药物，同时使毒副作用最小化。在简要描述癌组织的复杂性之后，对癌症化疗总体现状的一些方面进行了回顾。接着探讨了时间生物学在癌症治疗中的应用以及增加细胞毒性药物剂量和减少副作用的可能性。当实现最佳肿瘤细胞杀伤时，下一步是关注正常器官的昼夜节律方面，包括细胞更新迅速的组织的增殖行为。最后，讨论了如何干扰负责正常昼夜节律的调节机制的问题。当今结合现代输注技术的癌症时辰化疗是改善癌症总体治疗、减少副作用的一个有前景的领域，预计在不久的将来会取得重要进展。
