發(fā)布時間：2018-02-15 09:22

  本文關(guān)鍵詞： 骨轉(zhuǎn)移瘤 狄諾塞麥 RANK/RANKL/OPG軸　出處：《重慶醫(yī)科大學》2015年碩士論文　論文類型：學位論文

【摘要】：骨是實體腫瘤常見的轉(zhuǎn)移部位,骨轉(zhuǎn)移瘤導致的癌痛及骨相關(guān)事件(Skeletal related event,SRE),是晚期腫瘤患者生存質(zhì)量降低,甚至是直接威脅其生存的重要因素。結(jié)合目前治療惡性腫瘤骨轉(zhuǎn)移的現(xiàn)狀,其選擇繁多,包括藥物治療、放射治療、手術(shù)治療以及分子靶向治療,其中放射治療及手術(shù)治療均為局部對癥治療,而目前臨床運用較多的是藥物治療,其中應(yīng)用較為成熟的是雙磷酸鹽類,而本文所要講解的是另外一種分子靶向藥物——狄諾塞麥的基礎(chǔ)理論及其在臨床中的應(yīng)用(狄諾塞麥即核因子κB受體活化子配體(The receptor activator of nuclear factor kB ligand, RANKL)的單克隆抗體)。在惡性腫瘤骨轉(zhuǎn)移的基礎(chǔ)理論中,RANK/RANKL/OPG軸對破骨細胞的激活起關(guān)鍵作用,而狄諾塞麥的分子生物學基礎(chǔ)即是阻斷該條通路,從而達到阻斷骨轉(zhuǎn)移的作用,在增加骨密度(BMD)和延長骨相關(guān)事件的首發(fā)時間方面目前已取得確切療效,而對于早期癌癥病人預防骨轉(zhuǎn)移似乎也有一定的效果,但目前的研究數(shù)據(jù)對于我們更為關(guān)心的總生存時間的延長并無顯著作用,包括其對于預防和治療腫瘤的作用仍有待于進一步的試驗證明,但其對于骨巨細胞瘤的治療提供了新的選擇與希望,雖然目前發(fā)尚未成熟,但其前景及效果值得期待。本文主要對狄諾塞麥治療惡性腫瘤骨轉(zhuǎn)移的機制及其目前的進展作簡要的總結(jié)。
[Abstract]:Bone is the common metastatic site of solid tumor. The cancer pain caused by bone metastasis and bone related events Skeletal related event SRE, which is the quality of life of patients with advanced tumor, is decreased. Even an important factor that directly threatens their survival. Combined with the current status quo in the treatment of bone metastases from malignant tumors, there are a wide range of options, including drug therapy, radiation therapy, surgical treatment and molecular targeted therapy. Among them, radiotherapy and surgical treatment are local symptomatic treatment, but the current clinical use is more drug treatment, in which the more mature use of bisphosphates, What this paper is going to explain is the basic theory of another kind of molecular targeting drug, Dinosemer, and its clinical application (the receptor activator of nuclear factor kligand, RANKLL), which is the ligand of nuclear factor 魏 B receptor activator. In the basic theory of bone metastasis in malignant tumors, RANKR / RANKL / OPG axis plays a key role in the activation of osteoclasts. However, the molecular biological basis of Dinosemer is to block this pathway, thus blocking bone metastasis, and has achieved a definite effect in increasing bone density and prolonging the onset time of bone related events. And it seems to have some effect on preventing bone metastases in patients with early cancer, but the current research data have no significant effect on the overall survival time that we are more concerned about. Including its role in the prevention and treatment of tumors, which remains to be proved by further trials, but it offers new options and hopes for the treatment of giant cell tumor of bone, although it is not yet mature, But its prospect and effect should be expected. In this paper, the mechanism and current progress in the treatment of malignant tumor bone metastasis with Dinosemer were summarized.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R738.1

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