[Palliative therapy in cancer. 6. Quality of life and BRM therapy in cancer-patients]

Abstract

Almost all of anti-cancer drugs developed, injured not only the tumor cells but also the normal cells. For this reason, immunotherapy which injures specifically the tumor cells, has been developed. However, the clinical studies conducted in the past 20 years tend to indicate that even though the immunotherapy does not produce any serious side effect, the anti-tumor effect are not totally satisfactory in spite of marked prolongation of survivals. In recent years, various fields of cancer therapy have seen the development and application of treatment modalities which take into account the quality of the patients. Several patient's self-assessment questionnaires are widely used practical at the aims to assess what happens in the cancer-patients and to improve the cancer treatment. The measurements of quality of life have been performed on both immunochemotherapy group and chemotherapy group. The results showed the remarkable improvement of QOL in the immunochemotherapy group. The biotechnological advances have been made in the last 10 years. Various cytokines which participate in the immunological response between cancer and host. Many of these biologicals that will be called as biological response modifiers (BRM) are cell products of lymphocytes or macrophage. Systemic administration of exogenous cytokines to act against a tumor at a distant site may not be as successful as more localized therapy in situation. In most circumstances, cytokines are produced transiently at a local site acting in an autocrine or paracrine manner. Cytokines, whether naturally produced, or administered therapeutically, are rapidly clear from the circulation, both as a result of finding to often ubiquitous cell surface receptors, and by active excretion. So, the local injections of TNF and LAK cells are effective to decrease tumor size without the side effects. Finally, the serum level of IL-2 and TNF-alpha were determined for 24 healthy volunteers and 42 patients with advanced or terminal cancer, and the relationship between these levels and the QOL was investigated. In the cancer-patients who showed a higher serum level of IL-2 than the healthy volunteers, it was elucidated that there was an inverse correlation between the serum IL-2 level and the QOL. This finding cannot be explained at present, but it is surmised that, for this subpopulation of cancer-patients, the serum IL-2 level can probably serve as an objective biochemical index for use in evaluating the QOL.