抗癌药物的眼表影响研究进展

有效的抗癌药物是治疗癌症的重要武器,它可以帮助患者争取更长的生存时间。尽管癌症生存率上升,但抗癌药物带来的副作用也逐渐凸显出来,一些不良反应带来的眼表副作用可能会显著影响患者的生活质量,如细胞毒性化疗会带来上睑下垂、结膜炎、角膜糜烂等副作用,分子靶向药物可能会引起眼睑皮炎、倒睫、干眼等发生,眼球运动障碍则出现在免疫疗法的应用中。目前阐明眼表副作用的研究较少,发生机制尚未完全明确,但已有研究表明,眼表黏膜容易因长期暴露于含一定浓度化疗药物的泪液中而发生炎症;此外,眼表细胞的受体如雌激素受体和表皮生长因子受体可以与特异性抗癌药物发生反应,从而发生病理性改变。泪膜性质的改变也提示了抗癌药物带来的眼表影响及可能的机制。本文旨在陈述抗癌药物对眼表产生的潜在不良影响并探讨可能机制,以便在发生眼部不良反应时能够明确是否为药源性,从而调整治疗方案,避免眼表毒性的发生。

Research progress on the ocular surface effects of anticancer drugs

The use of drugs in cancer treatment is a crucial tool. Effective cancer drug therapy can aid patients in their battle for a longer survival period. However, the negative effects of anticancer medications become more noticeable as the survival rate for cancer rises. The quality of life of some individuals may be adversely impacted by some ocular surface side effects, such as ptosis, conjunctivitis and corneal erosion caused by cytotoxic chemotherapies; palpebral dermatitis, trichiasis and dry eye caused by the molecular targeted drugs; ocular motility disorder caused by immunotherapies. There are limited studies on the ocular surface side effects, and how they work is unclear. However, several investigations have demonstrated that prolonged contact with tears with a specific concentration of chemotherapeutic medicines makes the ocular surface mucosa more prone to inflammation. Furthermore, specific anticancer medications may interact with receptors in ocular surface cells, such as the estrogen receptor and the epidermal growth factor receptor, causing pathogenic alterations. Changes in tear film characteristics also point to potential mechanisms for how anticancer medications might affect the ocular surface. The purpose of this article is to describe the potential adverse effects of anticancer drugs on the ocular surface and explore the possible mechanisms. In this way, it can be clear whether the ocular adverse reactions are drug-induced, so as to adjust the treatment plan and avoid the occurrence of ocular surface toxicity.