具有细胞毒性的化疗药物帮助癌症患者生存?

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07/21/17(jkzx.com) – 临床肿瘤学杂志发表的2004年评论表明,细胞毒性化疗药物可能仅为癌症生存提供边际益处。在澳大利亚,检查结果显示,五年生存率大于60%,而化疗药物的贡献仅占2.3%。在美国,化疗药物仅贡献2.1%。

化疗药物是诱导用于杀死癌细胞的具有严重细胞毒性的药物。虽然许多癌细胞被杀死(药物不能100%杀死,特别是那些有变异的干细胞引起的癌症.),但健康的细胞也被杀死和受伤 (杀死还好,杀伤更糟)。更糟糕的是,所有的化疗药物都可以使癌细胞变得有耐药性,大多数药物可能引起继发性癌症如白血病 (化疗放疗可导致20到30%左右的病人得起继发性癌症)。并且还可以促进癌症向偏远器官的传播,并使早期癌症变为终末期癌症。

这个综述没有提到长期存活率(五年以上的)。由于化疗药物的非常严重的不良反应,似乎可以假定接受化疗治疗的癌症患者不仅需要忍受更多的疼痛和不良反应,并且他们的长期的生存率也有可能较低。

研究人员说化疗对五年生存的贡献很小。他们在报告中写道:“为了继续资助和使用细胞毒化学药物的药物,迫切需要严格评估它们成本效益和对生活质量的影响。”

评论:许多癌症患者不诉诸常规治疗如化疗和放射治疗得到癌症治愈,享受长期生存。考虑到化疗的痛苦和不利影响,癌症患者需要寻求替代治疗,无论他们使用化疗和放射治疗与否。(刘大卫)

How much do cytotoxic chemotherapy drugs help cancer patients survive?

A 2004 review published in Clinical Oncology suggests cytotoxic chemotherapy drugs may provide only marginal benefits to the cancer survival. In Australia, the review shows that the overall five-year survival rate is greater than 60% while the chemotherapy drugs contribute only 2.3%. And in the U.S., chemotherapy drugs contribute only 2.1%.

Chemotherapy drugs are those that induce severe cytotoxicity intended to kill cancer cells. While many cancer cells get killed, healthy cells get killed and injured too. Worse is that all the chemotherapy drugs can make the cancer cells drug resistant and the majority of the drugs can cause secondary cancers likely leukemia. And they can also promote the spreading of the cancer to remote organs and make early stage cancers stage 4 cancers or terminal cancers.

This review does not mention the longer term survival rate. Because of the highly severe adverse effects of chemotherapy drugs, it seems only logic to assume that cancer patients treated with chemotherapy suffer more pain and adverse effects, and probably have a low likelihood of longer than five-year survival.

The reviewers say the contribution of chemotherapy to the five-year survival is smaller. They write in their report “To justify the continued funding and availability of drugs used in cytotoxic chemotherapy, a rigorous evaluation of the cost-effectiveness and impact on quality of life is urgently required.”

Comment: Many cancer patients get their cancer cured and enjoy a long term survival without resorting to the conventional treatments like chemotherapy and radiation therapy. Considering the pain and adverse effects from chemotherapy, cancer patients need to seek alternative treatments no matter they use chemotherapy and radiation therapy or not. (David Liu)

Graeme Morgan, Robyn Wardy, Michael Bartonz (2004). Clinical Oncology 16, 549e560

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