口腔鳞状细胞癌时辰化疗中国专家共识
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摘要
化疗是口腔鳞癌的主要治疗方法之一,也是口腔鳞癌综合治疗的重要组成部分。然而,化疗药物在体内既杀伤癌细胞又杀伤正常细胞的"双刃剑"作用,使其临床应用受到一定限制。基于人体昼夜节律变化规律进行的时辰化疗比常规化疗更安全和更有效已被大量研究所证实,为了推广和规范该技术的临床应用,我们组织相关专家讨论并制定了专家共识。该共识对口腔鳞癌时辰化疗的原则、药物选择、给药时间和方法等给出了规范化建议,可供临床实践参考。
Chemotherapy is one of the main methods for treatment of oral squamous cell carcinoma, and it is also an important part of comprehensive treatment of oral squamous cell carcinoma. However, the "double-edged sword" effect of chemotherapeutic drugs in killing both cancer cells and normal cells in vivo has restricted its clinical application to a certain extent. Chrono-chemotherapy based on human circadian rhythm is safer and more effective than traditional chemotherapy, which has been confirmed by a large number of studies. In order to promote and standardize the clinical application of this technology, we organized relevant experts to discuss and formulate the chinese expert consensus. The consensus provides standardized suggestions on the principles, drug selection, administration time and methods of chronochemotherapy for oral squamous cell carcinoma, which can provide reference for clinical practice.
Chemotherapy is one of the main methods for treatment of oral squamous cell carcinoma, and it is also an important part of comprehensive treatment of oral squamous cell carcinoma. However, the "double-edged sword" effect of chemotherapeutic drugs in killing both cancer cells and normal cells in vivo has restricted its clinical application to a certain extent. Chrono-chemotherapy based on human circadian rhythm is safer and more effective than traditional chemotherapy, which has been confirmed by a large number of studies. In order to promote and standardize the clinical application of this technology, we organized relevant experts to discuss and formulate the chinese expert consensus. The consensus provides standardized suggestions on the principles, drug selection, administration time and methods of chronochemotherapy for oral squamous cell carcinoma, which can provide reference for clinical practice.
引文
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[26]Tsuchiya Y,Ushijima K,Noguchi T,et al.Influence of a dosingtime on toxicities induced by docetaxel,cisplatin and 5-fluorouracil in patients with oral squamous cell carcinoma;a cross-over pilot study[J].Chronobiol Int,2018,35(2):289-294.
[27]Therasse P,Arbuck SG,Eisenhauer EA,et al.New guidelines to evaluate the response to treatment in solid tumors.European Organization for Research and Treatment of Cancer,National Cancer Institute of the United States,National Cancer Institute of Canada[J].J Natl Cancer Inst,2000,92(3):205-216.
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[29]HHS,NIH,NCI.Common Terminology Criteria for Adverse Events(CTCAE)Version 4.0[DB/OL].2009.http://evs.nci.nih.gov/ftp1/CTCAE/About.html.
[2]Pfister D,Spencer S,Adelstein D,et al.NCCN clinical practice guidelines in oncology(NCCN GuidelinesR)for head and neck cancers.Version 2.2018.Fort Washington:National Comprehensive Cancer Network(NCCN)[DB/OL].2018.https://www.nccn.org/professionals/physician_gls/default.aspx.
[3]中国临床肿瘤学会指南工作委员会.头颈部肿瘤诊疗指南2018.V1[DB/OL].中国临床肿瘤学会(CSCO).2018.http://www.csco.org.cn/.
[4]曹雨庵,郭伟.我国口腔鳞癌的治疗现状[J].实用肿瘤杂志,2012,27(2):109-112.
[5]Ballesta A,Innominato PF,Dallmann R,et al.Systems chronotherapeutics[J].Pharmacol Rev,2017,69(2):161-199.
[6]Ortiz-Tudela E,Innominato PF,Rol MA,et al.Relevance of internal time and circadian robustness for cancer patients[J].BMC Cancer,2016,16:285.
[7]Ozturk N,Ozturk D,Kavakli IH,et al.Molecular aspects of circadian pharmacology and relevance for cancer chronotherapy[J].Int J Mol Sci,2017,18(10):E2168.
[8]FitzGerald GA.Circadian rhythms.Temporal targets of drug action[J].Science,2014,346(6212):921-922.
[9]Sehgal A.Physiology flies with time[J].Cell,2017,171(6):1232-1235.
[10]Turek FW.Circadian clocks:Not your grandfather's clock[J].Science,2016,354(6315):992-993.
[11]Innominato PF,Roche VP,Palesh OG,et al.The circadian timing system in clinical oncology[J].Ann Med,2014,46(4):191-207.
[12]Innominato PF,Lévi FA,Bjarnason GA.Chronotherapy and the molecular clock:Clinical implications in oncology[J].Adv Drug Deliv Rev,2010,62(9-10):979-1001.
[13]Ortiz-Tudela E,Mteyrek A,Ballesta A,et al.Cancer chronotherapeutics:experimental,theoretical,and clinical aspects[J].Handb Exp Pharmacol,2013,(217):261-288.
[14]Lévi F,Okyar A,Dulong S,at el.Circadian timing in cancer treatments[J].Annu Rev Pharmacol Toxicol,2010,50:377-421.
[15]Sancar A,Lindsey-Boltz LA,Gaddameedhi S,at el.Circadian clock,cancer,and chemotherapy[J].Biochemistry,2015,54(2):110-123.
[16]杨凯,陈睿,喻秀丽.口腔癌时辰化疗[J].实用口腔医学杂志,2005,21(3):389-391.
[17]Chen D,Cheng J,Yang K,et al.Retrospective analysis of chronomodulated chemotherapy versus conventional chemotherapy with paclitaxel,carboplatin,and 5-fluorouracil in patients with recurrent and/or metastatic head and neck squamous cell carcinoma[J].Onco Targets Ther,2013,6:1507-1514.
[18]Ye H,Yang K,Tan XM,et al.Daily rhythm variations of the clock gene PER1 and cancer-related genes during various stages of carcinogenesis in a golden hamster model of buccal mucosa carcinoma[J].Onco Targets Ther,2015,8:1419-1426.
[19]Callaway E,Ledford H.Medicine Nobel awarded for work on circadian clocks[J].Nature,2017,550(7674):18.
[20]Z hang R,Lahens NF,Ballance HI,et al.A circadian gene expression atlas in mammals:implications for biology and medicine[J].Proc Natl Acad Sci USA,2014,111(45):16219-16224.
[21]赵宁波,杨凯,唐洪,等.奥沙利铂对口腔鳞状细胞癌的时辰治疗[J].华西口腔医学杂志,2013,31(2):131-135.
[22]Zhao N,Tang H,Yang K,et al.Circadian rhythm characteristics of oral squamous cell carcinoma growth in an orthotopic xenograft model[J].Onco Targets Ther,2013,6:41-46.
[23]Hori K,Zhang QH,Li HC,et al.Timing of cancer chemotherapy based on circadian variations in tumor tissue blood flow[J].Int JCancer,1996,65(3):360-364.
[24]Blumenthal RD,Osorio L,Ochakovskaya R,et al.Regulation of tumour drug delivery by blood flow chronobiology[J].Eur JCancer,2000,36(14):1876-1884.
[25]杨凯,张福军,李雅冬,等.时辰新辅助化疗治疗老年人口腔鳞癌的临床研究[J].中华老年口腔医学杂志,2005,3(1):23-25.
[26]Tsuchiya Y,Ushijima K,Noguchi T,et al.Influence of a dosingtime on toxicities induced by docetaxel,cisplatin and 5-fluorouracil in patients with oral squamous cell carcinoma;a cross-over pilot study[J].Chronobiol Int,2018,35(2):289-294.
[27]Therasse P,Arbuck SG,Eisenhauer EA,et al.New guidelines to evaluate the response to treatment in solid tumors.European Organization for Research and Treatment of Cancer,National Cancer Institute of the United States,National Cancer Institute of Canada[J].J Natl Cancer Inst,2000,92(3):205-216.
[28]Eisenhauer EA,Therasse P,Bogaerts J,et al.New response evaluation criteria in solid tumours:revised RECIST guideline(version 1.1)[J].Eur J Cancer,2009,45(2):228-247.
[29]HHS,NIH,NCI.Common Terminology Criteria for Adverse Events(CTCAE)Version 4.0[DB/OL].2009.http://evs.nci.nih.gov/ftp1/CTCAE/About.html.