細胞，組織，腫瘤之動態學及其臨床應用

Cell, Tissue, Tumor Kinetics and its Clinical Applications

黃正仲(Jeng-Jong Hwang) ； 王懷詩(Hwai-Shi Wang) ； 林芳仁(Fang-Jen Lin)

《放射治療與腫瘤學》 3卷4期 (1996/12) Pp. 265-274

https://doi.org/10.6316/TRO/199603(4)266

摘要

學習腫瘤動態學的兩個主要目的為病人之預後及給予病人最好之治療方式。腫瘤內S期細胞分率和染色體倍數經常作為臨床上的治療指標。腫瘤內細胞在治療前後之動態變化牽涉到治療成敗甚鉅。例如S/M期或循環期細胞較多之腫瘤，應採用對這種細胞有較佳毒殺性之化療藥物或加速放射治療。目前化學治療使用之藥物不外兩種。一種是抑制DNA複製時所需之酵素，例如5-FU抑制胸腺嘧啶合成酵素而殺死S期細胞。第二種化學治療藥物則為破壞細胞分裂期之胞器，如vinblastine會破壞tubulin的聚合；cyclophosphamide會導致synaptonemal complex破碎而殺死M期細胞。放射治療則對於G2/M期細胞有較佳之殺傷力，對於S期細胞之殺傷效果則較差。因此臨床癌症常需配合多種治療方式。至於平均佔腫瘤內高達15%之缺氧細胞及G1/G0期細胞，則上述兩種治療方式均效果不佳。因此對於腫瘤內細胞之動態變化，有必要做深入探討。本文就細胞週期及其測定技術，生長分率，潛在腫瘤倍增時間，細胞損失及此等技術或觀念之臨床應用分別討論。對於生長分率，潛在腫瘤倍增時間及細胞損失因素則有較深入之探討。

關鍵字

細胞週期 ； 生長分率 ； 潛在腫瘤倍增時間 ； 細胞損失因素

並列摘要

The purpose of studying tumor kinetics are for the prognosis of patients and for the choice of the optimal treatment. S-phase fraction (SPF) as well as ploidy status of a tumor, for example, has been used frequently for prognosis and treatment guidance in clinic. The kinetics of a tumor before and after the treatment plays an important role which may affect the outcome of the therapy. For a tumor with high SPF, either the cytotoxic drugs specific for S- or M-phase cells should be used in chemotherapy or the accelerated treatment should be adopted in radiotherapy. There are two kinds of drugs currently used for clinical chemotherapy. One of which can inhibit the activity of the enzyme required for DNA replication, such as 5-fluorouracil which kills S-phase cells by inhibiting the activity of thymydylate synthetase. The second one killed M-phase cells by destructing the organelle required for mitotic processes, such as vinblastine which breaks tubulin assembly and cyclophosphamide which results in fragmentation of synaptonemal complex. Radiotherapy, on the other way, is more effective in killing G2/M cells but less effective for S-phase cells. Both treatments, however, are not very effective for hypoxic cells, which in average accounts for 15% of solid tumors, and those cells in the GJG0 stage. The more one understands the tumor kinetics, the higher control rate one may obtain. The following four subjects and their clinical applications were discussed: cell cycle and its measuring techniques, growth fraction, potential tumor doubling time and cell loss.

並列關鍵字

Cell cycle ； Growth fraction ； Potential tumor doubling time ； Cell loss