■总结当前知识,间隙,证据的质量,并显示与自主神经系统在肺癌中的作用有关的主要结果。
■研究是通过电子数据库确定的(PubMed,Scopus,Embase和Cochrane图书馆)于2023年10月进行,并进行了描述性分析。包括24项研究,大多数是观察性的。
■我们的数据表明肺癌中β-2-肾上腺素能受体的表达增加,这与不良预后有关。然而,使用β受体阻滞剂作为标准治疗的附加药物促进了总生存率的提高,无复发生存和减少转移发生。
■尽管本文的结果似乎很有希望,未来的研究需要使用高质量的前瞻性临床试验来指导临床干预。
肺癌是世界上癌症相关死亡的最常见原因之一。通常直到晚期才被诊断出来。最近,自主神经系统(交感神经和副交感神经系统)已被确定为癌症生长和扩散的调节剂,包括肺癌.事实上,临床前研究表明,肺癌自主神经支配可以引发肿瘤进展,转移,和对治疗的抵抗力,恶化预后。在这个意义上,一直在研究标准癌症治疗的附加策略,其中一项已经脱颖而出:在手术前或化疗期间附带使用β受体阻滞剂(使用β受体阻滞剂治疗高血压和/或心血管疾病或焦虑症的患者),这与改善的临床结果有关。因此,进行了范围审查,以总结有关证据质量的当前知识,与自主神经系统在人类肺癌中的作用有关的差距和主要结果。该综述的数据表明,肺癌患者的交感神经系统受体增加与预后较差有关。的确,在肺癌治疗的同时服用β-受体阻滞剂的患者的生存率提高,转移瘤发生率降低.尽管本文的结果似乎很有希望,需要进一步的前瞻性临床研究来研究有意和受控使用β受体阻滞剂作为附加策略对不同类型和分期的肺癌治疗的影响.
UNASSIGNED: To summarize current knowledge, gaps, quality of the evidence and show main results related to the role of the autonomic nervous system in lung cancer.
UNASSIGNED: Studies were identified through electronic databases (PubMed, Scopus, Embase and Cochrane Library) in October 2023, and a descriptive analysis was performed. Twenty-four studies were included, and most were observational.
UNASSIGNED: Our data indicated an increased expression of β-2-adrenergic receptors in lung cancer, which was associated with poor prognosis. However, the use of β-blockers as an add-on to standard treatment promoted enhanced overall survival, recurrence-free survival and reduced metastasis occurrence.
UNASSIGNED: Although the results herein seem promising, future research using high-quality prospective clinical trials is required to draw directions to guide clinical interventions.
Lung cancer is one of the most common causes of cancer-related deaths in the world, which often goes undiagnosed until it is in an advanced stage. Recently, the autonomic nervous system (sympathetic and
parasympathetic nervous systems) has been identified as a regulator of cancer growth and spread, including lung cancer. In fact, preclinical studies have demonstrated that autonomic innervation in lung cancer can trigger tumor progression, metastasis, and resistance to treatment, worsening the prognosis. In this sense, add-on strategies to standard cancer treatments have been investigating and one of them has stood out: the incidental use of β-blockers (patients who used β-blockers for the treatment of hypertension and/or cardiovascular diseases or anxiety) before surgeries or during chemotherapy, which has been associated with improved clinical outcomes. Thus, a scoping
review was conducted to summarizing the current knowledge about the quality of evidence, gaps and main results related to the role of the autonomic nervous system in human lung cancer. Data from this
review indicated an increase in sympathetic nervous system receptors associated with a worse prognosis in patients with lung cancer. Indeed, those patients who took β-blockers along with lung cancer treatment showed an increase in survival and a reduction in the occurrence of metastases. Although the results herein seem promising, further prospective clinical studies are needed to investigate the effect of the intentional and controlled use of β-blockers as an add-on strategy on the treatment of different types and stages of lung cancer.