Hartmann A, Vormstein M, Schnabel T, Kehren H, Stein T, Schmitt G, Makropoulos W
Klinik für Strahlentherapie und Radiologische Onkologie, Heinrich-Heine-Universität, Düsseldorf.
Strahlenther Onkol. 1996 Aug;172(8):434-8.
Deleterious effects of ionizing radiation and some chemotherapeutic agents are predominantly caused by reactive oxygen agents which are detoxified by antioxidants. This study was designed to evaluate the modifying effects of vitamin A-, vitamin E- and selenium serum concentrations and glutathione peroxidase activity on preoperative radio- and chemotherapy of breast cancer.
Tumor volume, vitamin A-, vitamin E-, selenium serum concentrations and glutathione peroxidase activity in circulating erythrocytes were determined in 40 patients with breast cancer before treatment. Interstitial radiohyperthermia was given initially using a single dose of 10 Gy (HDR) combined with hyperthermia between 43.5 to 44.5 degrees C over 60 minutes followed by external beam radiotherapy with 50 Gy in 5 weeks. All patients received anthracyline or anthrachinone containing chemotherapy. Tumor response was determined by histopathological examination. Patients with complete and incomplete remissions were compared using the Wilcoxon test. Pre- and posttreatment tumor-volume differences were correlated with antioxidant concentrations (Spearman correlation coefficient).
Twenty patients (50%) achieved a complete histopathologic tumor regression. This high complete remission rate was not related to the antioxidants under investigation (vitamin A: p = 0.32, vitamin E: p = 0.44, selenium: p = 0.68, glutathione peroxidase: p = 0.3). There was no correlation to pre- and posttreatment tumor-volume-differences either (vitamin A: p = 0.89, vitamin E: p = 0.67, selenium: p = 0.41, glutathione peroxidase: p = 0.87).
In this study serum concentrations of antioxidants had no modifying influence on tumor response in breast cancer patients following induction radio-chemotherapy and subsequent surgery. Further studies measuring tissue levels could clarify if there is any modifying influence of antioxidants on tumor remission.
电离辐射和某些化疗药物的有害作用主要由活性氧物质引起,而抗氧化剂可使其解毒。本研究旨在评估维生素A、维生素E、血清硒浓度以及谷胱甘肽过氧化物酶活性对乳腺癌术前放疗和化疗的调节作用。
测定40例乳腺癌患者治疗前的肿瘤体积、维生素A、维生素E、血清硒浓度以及循环红细胞中的谷胱甘肽过氧化物酶活性。最初给予间质放射热疗,单次剂量10 Gy(高剂量率),同时在43.5至44.5摄氏度下进行60分钟的热疗,随后在5周内进行50 Gy的外照射放疗。所有患者均接受含蒽环类或蒽醌类的化疗。通过组织病理学检查确定肿瘤反应。使用Wilcoxon检验比较完全缓解和不完全缓解的患者。治疗前后肿瘤体积差异与抗氧化剂浓度进行相关性分析(Spearman相关系数)。
20例患者(50%)实现了肿瘤组织病理学完全消退。这种高完全缓解率与所研究的抗氧化剂无关(维生素A:p = 0.32,维生素E:p = 0.44,硒:p = 0.68,谷胱甘肽过氧化物酶:p = 0.3)。与治疗前后肿瘤体积差异也无相关性(维生素A:p = 0.89,维生素E:p = 0.67,硒:p = 0.41,谷胱甘肽过氧化物酶:p = 0.87)。
在本研究中,抗氧化剂的血清浓度对乳腺癌患者诱导放化疗及后续手术后的肿瘤反应没有调节作用。进一步测量组织水平的研究可能会阐明抗氧化剂对肿瘤缓解是否有任何调节作用。