Hehr T, Hoffmann W, Bamberg M
Abteilung für Strahlentherapie, Radiologische Universitätsklinik, Tübingen.
Med Klin (Munich). 1997 Sep 15;92 Suppl 3:48-9. doi: 10.1007/BF03041966.
In various epidemiologic studies an association of low selenium blood levels and reduced glutathione peroxidase with an increased risk of cancer incidence was described. The antitumoral therapy and a suboptimal nutrition could intensify this deficiency. Every reduction of disease related and therapeutic caused symptoms may improve life quality.
We report our preliminary experiences in the adjuvant radiochemotherapy of advanced rectal cancer (UICC II/III) corresponding to the NCl recommendation. An oral selenium supplementation was carried out with 2000 micrograms Na2SeO3 after every course of fluorouracil chemotherapy and daily 400 micrograms Na2SeO3 after irradiation of tumor region and lymph nodes. A weekly life quality assessment was explored with special interest in diarrhea, dysurie, pain, appetite, nausea and emesis.
Damages to normal tissue specially to DNA enzymes and membranes caused by free radicals is one mechanism in tumorgenesis, tumor progression and therapeutic consequence. A radioprotective effect of selenium is verified by in vitro and in vivo data. Our data show that oral selenium intake in rectal cancer patients is easily tolerated with no side effects. Improving life quality and secondary cancer prevention with supplementation of selenium has to be proven in prospective randomized studies.
在各种流行病学研究中，均描述了血硒水平低和谷胱甘肽过氧化物酶降低与癌症发病率增加之间的关联。抗肿瘤治疗和营养欠佳可能会加剧这种缺乏。减轻与疾病及治疗相关的症状或许可以改善生活质量。
我们报告了依据美国国立癌症研究所（NCl）建议，在晚期直肠癌（国际抗癌联盟II/III期）辅助放化疗中的初步经验。在每疗程氟尿嘧啶化疗后口服2000微克亚硒酸钠进行补硒，在肿瘤区域及淋巴结放疗后每日口服400微克亚硒酸钠。每周进行一次生活质量评估，特别关注腹泻、排尿困难、疼痛、食欲、恶心和呕吐情况。
自由基对正常组织尤其是DNA酶和细胞膜造成的损伤是肿瘤发生、发展及治疗结果的一种机制。体外和体内数据均证实了硒的辐射防护作用。我们的数据表明，直肠癌患者口服补充硒易于耐受且无副作用。通过补硒改善生活质量和预防继发性癌症有待在前瞻性随机研究中得到证实。
