癌症治疗新希望
转自丁香园 yingtiao编译
Poor diet, too much alcohol, smoking and increasing obesity could be leading to an epidemic of oesophageal and upper stomach cancer, according to a leading UK team of specialists at The University of Nottingham and Nottingham University Hospitals
.
英国诺丁汉大学和诺丁汉大学附属医院的专家团队称：糟糕的饮食，酗酒，吸烟和过度肥胖将导致越来越多的食道癌和胃癌发生。
The Nottingham Gastro-Oesophageal Cancer Research Group has been carrying out intensive research over the past five years to try to improve the treatment of this cancer. A major part of the research is published today in the British Journal of Cancer. The work has been prompted by a large increase in the incidence of cancer of the oesophagus (gullet) and upper stomach over the past 40 years.
过去五年中，诺丁汉食道-胃研究小组进行了一项详细的研究，试图改善这类肿瘤的治疗效果。研究的大部分成果今天被刊登在英国肿瘤杂志上。过去40年剧增的食道癌和胃癌发病率推动了该研究的进展。
According to Cancer Research UK statistics, rates of oesophageal adenocarcinoma and gastro-oesophageal (GOJ) adenocarcinoma have been increasing in the UK. Since the 1970s the incidence of this cancer has increased by 50 per cent in men and 20 per cent in women. Indeed the reported rates for white men in the UK are now the highest in the world.
根据英国肿瘤研究小组的统计，食道腺癌和胃食道腺癌在英国的发病率一直在上升。和20世纪70年代相比，这类肿瘤的发病率在男性中上升了50个百分点，女性中上升了20个百分点。英国白人的发病率排在世界第一位。
Doctors believe changes in diet and lifestyle are the key factors behind the rapid rise in the number of cases. This new research is aimed at providing a better treatment and prognosis for a cancer that is historically not survivable past five years from diagnosis. Current standard treatment for potentially operable cancer consists of a 12 week intensive course of powerful chemotherapy, followed by surgery if the tumour is operable, and then a second 12 week course of chemotherapy. This prolonged, intense course of chemotherapy treatment is potentially toxic, impacts on quality of life and is likely to be beneficial only in those patients who respond to chemotherapy.
医生们相信饮食和生活习惯的改变是导致此类病例剧增的首要原因。该研究旨在为这种确诊后生存期不足五年的疾病提供更佳的治疗和预后。对于此类肿瘤，当前治疗包括12周强化化疗，如果可以手术再接受手术治疗，之后再接受12周化疗。这种长期的强化化疗毒性很大，影响生活质量，可能只对化疗敏感的患者有效。
The Nottingham-based research using molecular cancer pathology and DNA protein expression techniques on tumour samples from around 250 patients after surgery has shown that only between 40 per cent and 50 per cent of these adenocarcinomas actually respond to the chemotherapy. The research has effectively tested a very promising monitoring test during treatment so that doctors can assess whether and how far the tumour is regressing during chemotherapy. In addition, the research has also identified a promising protein marker involved in DNA repair in cancer cells that predicts resistance to chemotherapy in tumours.
该研究小组使用分子肿瘤病理和DNA蛋白表达技术，对250名术后患者的肿瘤标本进行检测，发现只有40%到50%的腺癌患者对化疗敏感。同时，该小组还还测试了另一种有潜力的监测手段，使医师可以评估肿瘤对化疗的反应。此外，还发现了一种与肿瘤细胞DNA修复有关的蛋白标记物，可预测肿瘤对化疗的敏感性。
The new information could empower doctors to decide whether to recommend a second course of powerful chemotherapy after surgery. The research also paves the way for wider and more specialised clinical trials for this cancer which will monitor patients in real-time, rather than using past samples, and which could lead to new combinations of chemotherapy, including the new breast cancer drug, Herceptin, which has recently been proven to be effective in gastro-oesophageal cancers.
这些新发现可以帮助医师控制局势，决定是否在术后向患者推荐二次化疗。这项研究还为进一步的临床实验铺平了道路，对患者进行实时监测而非使用过去的标本，还可能产生新的联合化疗方案，包括已证实对胃-食管癌有效的新型乳癌治疗药物Herceptin，
Dr Srinivasan Madhusudan, Clinical Associate Professor & Consultant in Medical Oncology at Nottingham University Hospitals and the University's School of Molecular Medical Sciences, said: "Recent scientific advances have given real hope for patients with gastro-oesophageal cancers. The Nottingham Upper Gastrointestinal Cancer Group is a multidisciplinary research team consisting of Oncologists, Surgeons, Pathologists and Radiologists. We aim to exploit the 'new science' for patient benefit. This study published online today in the British Journal of Cancer provides evidence that it may be possible to tailor gastro-oesophageal cancer treatments based on 'new' biology. We are planning a larger prospective multicentre study to confirm these findings and we believe will have major clinical impact on how we treat these aggressive tumours in the future."
Srinivasan Madhusudan博士说：最近的科学进展为食管-胃癌患者真正带来了希望。诺丁汉小组是一个多学科研究团队，涉及肿瘤学，外科学，病理学和放射医学。为了病人的利益我们探索新的科学。今天发表在英国肿瘤杂志的这篇文章表明可能根据这一新的发现来调整胃-食管肿瘤的治疗。我们正计划一项多中心研究，以证实这些发现，我们相信这项研究将对将来这些肿瘤的研究产生重大影响。
Source: Nottingham University
View drug information on Herceptin.
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