青蒿琥酯对肿瘤放化疗增敏作用的研究现状分析和展望

Current research analysis and prospects on sensitization effect of artesunate on anti-cancer radiotherapy and chemotherapy

青蒿素类药物在抗肿瘤治疗中的广泛应用一定程度上反映了中西医抗肿瘤治疗的优势。国内外已有基础和临床研究表明,青蒿琥酯(artesunate,ART)可有效干预乳腺癌、结肠癌、白血病、黑素瘤、卵巢癌、前列腺癌、肾癌和多种中枢神经系统瘤的恶性进展,其作用机制亦体现在多方面,如抑制肿瘤细胞增殖侵袭转移、诱导肿瘤细胞凋亡和自噬、调控细胞信号转导和抑制肿瘤血管新生等。同时,越来越多的实验证据表明,ART对多种抗肿瘤放射疗法(如X射线、β射线、γ射线、60Coγ射线等)和化学药物疗法(如顺铂、卡铂和阿霉素等)均起到了显著的增敏作用。故该文调研了文献数据库PubMed和CNKI,围绕2000年4月至2019年2月ART发挥抗肿瘤放化疗增敏作用的基础和临床研究进行了归纳总结,并对ART干预肿瘤的临床定位与扩大其应用范围提出了展望,旨在较为全面地了解ART对肿瘤放化疗增敏作用的研究现状,为寻找放化疗增敏剂和肿瘤耐药逆转剂提供启示和思路。

The wide application of artemisinins in the treatment of multiple cancers reflects the advantages of traditional Chinese medicine used in this field. The existing basic and clinical studies have revealed that artesunate can effectively suppress the malignant progression of breast cancer,colon cancer,leukemia,melanoma,ovarian cancer,prostate cancer,kidney cancer and various tumors in central nervous system. The pharmacological mechanisms of artesunate against cancers are reflected in many aspects,such as inhibiting tumor cell proliferation,invasion and metastasis,inducing tumor cell apoptosis and autophagy,regulating cell signal transduction and inhibiting tumor angiogenesis. Meanwhile,growing experimental evidences have indicated that artesunate has been used for the sensitization of radiotherapy with X-ray,β-ray,γ-ray and60Co γ-ray,as well as chemotherapy with cisplatin,carboplatin and doxorubicin.This review collected basic and clinical studies on the sensitization effect of artesunate on anti-cancer radiotherapy and chemotherapy published on PubMed and CNKI during April 2000 and February 2019,and summarized the clinical positioning and application of artesunate,with the aim to provide a more comprehensive explanation on the sensitization effect of artesunate on anti-cancer radiotherapy and chemotherapy,and offer the inspiration and ideas for the development of radiotherapy and chemotherapy sensitizers,as well as cancer resistance reversal agents.