抗肿瘤缓释剂在消化道肿瘤化疗中的应用与评价

Application of anti-tumor sustained-release reagents in chemotherapy of gastrointestinal cancer and therapeutic effect evaluation

目的:评价抗肿瘤缓释剂在消化道肿瘤中的应用,寻找合理的治疗方案。方法:以"食道癌,胃癌,肝癌,肠癌,植入化疗,缓释植入剂,化学药物"为中文关键词;以"esophageal cancer,gastric cancer,liver cancer,coloncancer,implantation of chemotherapy,sustained release implants,chemicals"为英文关键词。采用计算机检索1993-01/2009-10相关文章。纳入与有关生物材料及组织工程血管相关的文章;排除重复研究或Meta分析类文章。结果:植入式化疗的缓释植入剂(即化疗药物)通过不同载体和制备工艺限制药物的溶出和扩散速度,并经聚合物的降解将药物缓慢、持续、相对稳定、最大浓度在局部发挥作用。在消化道瘤内或肿瘤残留灶及可能有微小转移瘤灶区域植入化疗缓释剂,既提高了肿瘤局部药物浓度及作用时间,同时也降低或避免了全身化疗常见的毒副反应,为肿瘤的化学治疗提供了一条新的给药途径;肿瘤内直接注入化疗缓释剂也为一些失去手术、放疗或不能耐受全身化疗的晚期肿瘤患者减少痛苦并带来新的希望。结论:抗肿瘤缓释剂可作为一种较理想的缓释植入剂应用于消化道癌症。

OBJECTIVE：To evaluate the application of anti-tumor sustained-release reagent in gastrointestinal tumors,and to find a reasonable treatment.METHODS：Using ＂esophageal cancer,gastric cancer,liver cancer,colon cancer,implantation of chemotherapy,sustained-release implants,chemical drugs＂ as the Chinese keywords and ＂esophageal cancer,gastric cancer,liver cancer,colon cancer,implantation of chemotherapy,sustained release implants,chemicals＂ as the English keywords,a computer search was performed among articles published between January 1993 and October 2009.Articles related with the biological materials and tissue engineering blood vessels were included;repeated study or Meta analysis articles were excluded. RESULTS：The implanted sustained-release implants of chemotherapy（i.e.chemotherapeutics） may restrict the drug dissolution and diffusion rate through different carriers and preparation techniques,slowly and continuously release drugs,those drugs at a relatively stable maximal concentration only works in local part.In the digestive tract tumor or residual tumor and possible tiny tumor metastases locus,we may implant sustained-release chemotherapy reagents,thus improving local drug dose and action time,while reducing or avoiding side effects caused by the common chemotherapy,providing a new route of administration for chemical treatment of tumors;intratumoral injection of chemotherapy sustained-release reagent can reduce pain and bring new hope for tumor patients at advanced stage who are absent for surgery,radiotherapy or common chemotherapy.CONCLUSION：The anti-tumor sustained-release reagent can be used as an ideal sustained-release implant in digestive tract cancer.