MEHMET GİRAY SÖNMEZ
(Medical Park Ankara Hastanesi, Üroloji Bölümü, Ankara, Türkiye)
Cengiz KARA
(Medical Park Ankara Hastanesi, Üroloji Bölümü, Ankara, Türkiye)
MEHMET KAYNAR
(Selçuk Üniversitesi, Selçuklu Tıp Fakültesi, Üroloji Anabilim Dalı, Konya, Türkiye)
Yıl: 2016Cilt: 11Sayı: 1ISSN: 1305-2489Sayfa Aralığı: 64 - 70Türkçe

140 5
Böbrek ve mesane tümörlerinde aşı tedavileri
Genel olarak aşı tedavisi çeşitli kanserlerin tedavisinde kullanılabilir. Ancak tüm araştırmalara rağmen henüz pek çok kanser türünde başarılı olunamamıştır. Aşı tedavisinin uygulanabilmesi için; kanserin immünojenik olması ve dokuya özgü proteinler içermesi, yavaş ilerlemesi, tedavilerin uygulanabilir olması gereklidir. Bu nedenle, ürolojik kanserler içinde çoğu faz 1/2 ve faz 3 olmak üzere çalışmalar böbrek ve prostat, daha az miktarda da mesane üzerine yoğunlaşmıştır (1,2). Testis kanserlerinde aşı çalışmalarının olmaması hızlı yayılım ve metastaz göstermesi, çeşitli olması ve genellikle mix tümörler halinde izlenmesi, kantestis bariyerinin olması olarak açıklanabilir.Aşı tedavisinin kullanımında amaç; tümörün tetiklediği toleransı yenerek, malign hücrelere karşı oluşan immun cevabı aktive etmektir. Bu tedaviler kansere karşı immun cevabı kullanarak etki göstermektedir. Literatür de yayınlanan ilk onkolojik aşı tedavisi 1893 yılında Coley tarafından yayınlanmıştır. Bu çalışmada inoperable yumuşak doku sarkomlarının streptokokal toksinler ile non-spesifik immün cevap oluşturulurak regrese olduğu gösterilmiştir (3). Üroonkolojide kullanılan aşılar; tümör hücreleri (otolog ve allojenik), dentritik hücre, DNA viral vektör, protein/peptid, immün düzenleyiciler olmak üzere ana başlıklar halinde sayılabilir (4). Böbrek ve mesane tümörlerinde aşı tedavilerinin uygulanmasına ait geçmiş çalışmalar olmasına rağmen özellikle araştırmalar son dönem de yoğunlaşmıştır. Biz de bu derlemede üroloji hekimlerinin çok aşina olmadığı, güncel literatür eşliğinde böbrek ve mesane tümörlerinde kullanılan aşı tedavilerinden bahsedeceğiz.
Fen > Tıp > Üroloji ve Nefroloji
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