Tsukuda M
Department of Otolaryngology, Yokohama City University School of Medicine, Japan.
Gan To Kagaku Ryoho. 1996 Feb;23(3):283-90.
The decline of immunity has been reported in head and neck carcinomas in the advanced stage. On the basis of this finding in head and neck carcinomas, additional immunotherapy in curative treatment, i.e., surgical therapy and/or radiation therapy, has been applied for patients with advanced tumors to improve their poor prognosis. Until now, only a few controlled randomized studies have evaluated the clinical efficacy of non-specific immunotherapy, i.e., Ubenimex and OK-432. Each result using these drugs showed that the survival rate in those receiving non-specific immunotherapy was higher than in the control. Cytokines, e.g., IFN-alpha, gamma, TNF-alpha, had immunologically modulating actions on the immunological conditions of patients and on the tumor cells, whereas immunotherapy using these cytokines has not shown a good clinical response, as with clinical administration of IL-2 alone. Furthermore, the clinical results of combined therapy of IL-2 and adoptive immunotherapy for head and neck carcinomas have not been satisfactory. In future, to improve the prognosis in patients with these carcinomas, it is indispensable to develop a new immunotherapy including transfer of cytokine-transfected cells having tumor-immunization ability and capable of inducing cytolytic effector cells in the peritumoral site, and specific antibody therapy against tumor cells.
据报道,晚期头颈癌患者存在免疫功能下降的情况。基于头颈癌的这一发现,对于晚期肿瘤患者,在根治性治疗(即手术治疗和/或放射治疗)中增加了免疫治疗,以改善其不良预后。到目前为止,只有少数对照随机研究评估了非特异性免疫治疗(如乌苯美司和OK-432)的临床疗效。使用这些药物的每项结果都表明,接受非特异性免疫治疗的患者生存率高于对照组。细胞因子,如干扰素-α、γ、肿瘤坏死因子-α,对患者的免疫状况和肿瘤细胞具有免疫调节作用,然而,使用这些细胞因子进行免疫治疗并未显示出良好的临床反应,就像单独临床应用白细胞介素-2一样。此外,白细胞介素-2与过继性免疫治疗联合用于头颈癌的临床结果并不令人满意。未来,为了改善这些癌症患者的预后,开发一种新的免疫治疗方法必不可少,这种方法包括转移具有肿瘤免疫能力且能够在肿瘤周围部位诱导溶细胞效应细胞的细胞因子转染细胞,以及针对肿瘤细胞的特异性抗体治疗。