癌症恶病质药物治疗研究进展

Progress in drug treatment of cancer cachexia

癌症恶病质是晚期肿瘤患者的常见综合征,它主要由于蛋白质、脂肪和糖代谢严重紊乱而导致出现厌食、体重下降、骨骼肌消耗和乏力等恶病质表现。近年来认为其发病机制主要是肿瘤产物和宿主细胞因子(TNF-α、IL-1和IL-6)释放共同作用所致。因此目前针对癌症恶病质的药物治疗主要以促进食欲、抗分解代谢(抗细胞因子)和同化激素类药物为主,以改善患者生活质量和延长生存期。这类药物除了皮质醇激素和孕激素之外,还包括细胞因子拮抗剂、沙立度胺、己酮可可碱、鱼油、褪黑激素、支链氨基酸、中药等。

Cancer cachexia is a common syndrome in advanced cancer patients, which is characterized by profound changes in protein, fat and carbohydrate metabolism, resulting in anorexia, weight loss, muscle wasting and poor performance status. In recent years, cachexia has been understood as the result of major metabolic abnormalities due to a combination of host cytokine release （TNF- a, IL- 1, and IL- 6） and tumor products. At present, the pharmacological treatments, including orexigenic （appetite stimulants）, anti - catabolic （and anti - cytokine） and anabolic agents, all aim to improve the quality of life and extend survival period. Pharmacological treatments, beside that of hydrocortisone and progastogen, include the use of agents currently under investigation for cancer cachexia, such as cytokine antagon, thalidomide, pentoxifylline, fish oil, melatonin, branched - chain amino acids and traditional Chinese medicine.