静脉注射大剂量维生素 C(HVC)具有低毒性、低成本的优点,可与其他治疗方式联合作为抗肿瘤治疗的新兴策略。 其抗肿瘤的机制主要是过氧化应激,HVC 可通过产生过氧化氢(H2O2 )、与 Fe 2+发生芬顿反应产生羟自由基(OH·)、脱氢抗 坏血酸(DHA)还原等途径杀伤肿瘤细胞。 HVC 也可氧化还原金属粒子调节相关酶的活性,来影响表观基因组调节及氧调节。 另外,HVC 可通过增强免疫功能、抑制肿瘤转移侵袭等机制发挥作用。 大量临床前模型显示 HVC 联合治疗具有增加治疗效 果,减轻相关不良反应的作用。 Kirsten 大鼠肉瘤病毒癌基因同源物(KRAS)和鼠类肉瘤病毒癌基因同源物 B1(BRAF)突变、第 10-11 碳转位(TET)蛋白等可能是潜在的治疗靶点。 目前 HVC 联合治疗的临床研究包括结直肠癌、胃癌、胰腺癌、肺癌、卵巢 癌、血液肿瘤等,证实了 HVC 联合治疗安全性良好,并且初步分析具有一定的抗肿瘤疗效。 但大多是单中心小样本的研究,未 来仍需要大样本、前瞻性的随机对照试验进一步探索 HVC 抗肿瘤治疗的效果,并对抗肿瘤机制进一步研究筛选出治疗敏感的 标志物。

High-dose intravenous vitamin C HVC has the advantages of low toxicity and low cost and can be combined with other treatments as an emerging treatment strategy for anti - tumor. Its anti - tumor mechanism is mainly pro - oxidative stress. HVC can produce hydrogen peroxide H2O2 produce hydroxyl radicals OH· by Fenton reaction with Fe 2+ and dehydroascorbic acid DHA reduction to kill tumor cells. It can also affect epigenetic regulation and oxygen regulation through the regulation of enzyme activity by redox-active metal particles. In addition HVC can play a role by enhancing immune function and inhibiting tumor metastasis and invasion. A large number of preclinical have shown that HVC can increase the therapeutic effect and reduce the treatment-related adverse reactions. Kirsten rats arcomaviral oncogene homolog KRAS and v-raf murine sarcoma viral oncogene homolog B1 BRAF mutations ten-eleven translocation TET enzymes etc. may be potential therapeutic targets. At present the clinical studies of HVC combined therapy include colorectal cancer gastric cancer pancreatic cancer lung cancer ovarian cancer hematological tumors etc. confirming that HVC combined therapy is safe and has a certain anti-tumor effect. However most of the current studies are single-center and small-sample studies. In the future large-sample prospective randomized controlled trials are still needed and further explore the anti-tumor mechanism of HVC to screen out treatment-sensitive markers.