恶性肿瘤治疗的新策略—基因—病毒治疗

本文较系统地介绍了几种增殖病毒治疗肿瘤的最近进展。目前最为有效的增殖病毒是ONYSX-015,它与常规化疗联合,可产生令人鼓舞的临床疗效。但单独应用,其病毒杀伤力仍不足,从而提出了一种新型的肿瘤治疗新策略。即基因-病毒治疗法,该方案充分利用增殖病毒及基因治疗的优势,它可能成为肿瘤治疗最有效的方案之一。     

Neutron Therapy

In recent years considerable progress has been made in the application of neutron sources to the treatment of cancer. The development of this field is outlined, and a review is given of the current status of published clinical experience. A variety of sources can be used for neutron therapy and their relative merits are discussed. Proposals for an Australian facility for neutron therapy are put forward.     

Antisense Therapy

The technique of gene silencing using antisense oligonucleotides is of high interest to investigators involved in drug development. In theory, this technology provides a means of specifically targeting the expression of a single gene product. The ever-expanding field of antisense technology now covers a wide range of substances including oligonucleotides, peptide nucleic acids as well as small interfering ribonucleic acids or RNA interference. Antisense technology has developed over the past decade to the stage where there are now several clinical trials evaluating the safety as well as efficacy of these agents in clinical oncology. With rapid developments in synthesis of the oligonucleotides, modifications that make the oligonucleotides more stable, and identification of more tumor-specific targets, it is likely that antisense oligonucleotides will become useful in cancer therapy. These drugs appear to be well tolerated and may be combined with conventional chemotherapeutic agents for better antitumor effects.     

Preoperative Endocrine Therapy: Preferred Therapy for Whom?

Neoadjuvant endocrine therapy is safe and can be effective in many postmenopausal women with estrogen receptor positive breast cancer. There are limited data available for premenopausal women taking aromatase inhibitors in combination with estrogen suppression. Letrozole, anastrozole, and exemestane have all been shown to be equivalent or superior to tamoxifen in relatively small neoadjuvant trials in postmenopausal women. Tumor factors that appear to have good response are estrogen receptor positivity, characteristics consistent with the so-called Luminal A subtype and lobular carcinomas. Response to neoadjuvant treatment may inform decision making regarding adjuvant treatment, which should include radiotherapy following breast-conserving surgery, or mastectomy, made feasible by neoadjuvant treatment to maintain low local recurrence rates. Chemotherapy may also be required in some cases based on the biological characteristics of the residual tumor and the extent of residual disease.     

Moderators of Psycho-Oncology Therapy Effectiveness: Meta-Analysis of Therapy Characteristics

As part of a larger meta-analysis seeking moderators of the effectiveness of psycho-oncological interventions, this report focuses on intervention types and characteristics, including protocol components, means of delivery (mode, dose, and therapist variables), and mechanisms of effectiveness. The data set comprised 146 published and unpublished prospective controlled trials with outcomes of anxiety, depression, and distress. Analyses took into account two moderators from analysis of study design features. The authors conclude that each of the four main professional therapy types (education, relaxation, cognitive behavior therapy (CBT), and expressive-support) has effect and that it is more important to focus on participant variables, notably, elevated baseline distress. Therapy components delivered by nonprofessionals and interventions that affect the patient indirectly show potential. Recommendations for practice and research are made.     

Therapy of entamebiasis

Therapy of entamebiasis is critical in that, if untreated, the disease can be fatal. Recently, a new method for differentiating pathogenic and non-pathogenic amebae has been standardized. This method relies upon the electrophoretic analysis of 4 isoenzymes which allow the identification of 20 different zymodemes. It is now widely accepted that non-pathogenic strains of Entamoeba histolytica are not a hazard for humans and therefore don't need therapy. As a consequence, treatment must be addressed only toward infections caused by pathogenic strains. As there are different drugs available for treating amebiasis, from a therapeutical point of view the disease must be divided into two forms: intestinal and extraintestinal. For the former, drugs which reach therapeutical levels in the gut are required. The mainstay for the treatment of asymptomatic carriage of pathogenic strains is DILOXANIDE FUROATE, a very well tolerated luminal amebicide. METRONIDAZOLE and other 5-nitroimidazole compounds such as ORNIDAZOLE are indicated for the treatment of symptomatic intestinal infections as they reach good concentrations in tissues, including the bowel where ulcerations develop. In order to ensure the clearance of amebae from the gut, a subsequent cycle with diloxanide furoate is advisable. Extraintestinal forms include amebic abscesses which can develop in many sites, but most commonly in the liver. Metronidazole and related compounds are the drugs of choice; in case of liver abscess, the addition of CHLOROQUINE is indicated because of its good concentration in tissues. A subsequent cycle with diloxanide furoate is also indicated.(ABSTRACT TRUNCATED AT 250 WORDS)