NORML: 膠質母細胞瘤

膠質母細胞瘤，神經膠質瘤（腦部腫瘤）是特別具攻擊性的惡性癌症形式，常常導致患者在診斷後12至18個月內死亡。對於神經膠質瘤目前並無治癒方法，大部分可用的治療僅提供輕微的症狀緩解。

現代科學文獻的綜述顯示，許多前臨床研究以及有限的個案報告和人類研究表明，大麻素具有作為抗腫瘤劑的能力，特別是在神經膠質瘤細胞系上。

1998年9月，馬德里康普頓斯大學生物學院的研究人員首次報導，在神經膠質瘤細胞培養物中，delta-9-四氫大麻酚（THC）可誘導細胞凋亡（程式性細胞死亡）。[1] 研究人員在2000年跟進了初步發現，報告稱，THC和合成大麻素激動劑WIN 55,212-2的施用, 在動物中“誘導了惡性神經膠質瘤的顯著退化”。[2] 研究人員在2003年再次確認了大麻素抑制神經膠質瘤腫瘤生長的能力。[3]

同年，意大利研究人員也報導了非致幻大麻素—大麻二酚（CBD）在體內和體外以劑量依賴性方式抑制各種人類神經膠質瘤細胞系的生長。在2003年11月的《藥理學與實驗治療學雜誌》中，研究人員總結道：“非致幻的CBD … 在體內和體外均產生顯著的抗腫瘤活性，這表明CBD作為抗腫瘤劑的可能應用。”[4]

2004年，Guzman及其同事報導，大麻素透過改變血管形態（如VEGF通路），抑制動物及人類多形性膠質母細胞瘤（GBM）腫瘤的生長。研究人員在2004年8月的《癌症研究》期刊中寫道：“目前的實驗室和臨床結果提供了大麻素治療的新藥理目標。”[5]

加州太平洋醫療中心研究所的研究人員報告指出，向人類多形性膠質母細胞瘤細胞系施用THC，比施用合成大麻素激動劑WIN 55,212-2更能減少惡性細胞的增殖，並更迅速地誘導細胞死亡。研究人員還指出，THC選擇性地針對惡性細胞，而忽略健康細胞，其作用比合成替代品更為顯著。[6] 另一項前臨床試驗報告指出，將THC和藥物溶瘤莫司（TMZ）聯合施用，“增強自噬”（程式性細胞死亡），對抗傳統抗癌治療難治的腦腫瘤。[7]

有限的人類研究也顯示出類似的結果。2006年，Guzman及其同事進行了首次臨床試驗，評估大麻素在GBM中的顱內使用。研究人員發現，向腫瘤內部施用THC與九名受試者中的兩名減少腫瘤細胞增殖相關。“THC的良好安全性資料，加上其對腫瘤細胞的抗增殖作用，在本研究及其他研究中所報告的結果，為未來旨在評估大麻素潛在抗腫瘤活性的試驗奠定了基礎，”研究人員總結道。[8] 其他一些研究者也呼籲進一步探討基於大麻的療法治療神經膠質瘤的可能性。[9-11]

2017年，英國生物技術公司GW Pharmaceuticals的研究人員宣布，植物衍生的大麻萃取物輔助使用與膠質瘤患者的生存時間延長有關。接受醫用大麻治療的試驗參與者的中位生存期為550天，而未使用者的中位生存期為369天。[12]

少數的病例報告也提供了有希望的證據。一篇於2011年發表在《國際兒童神經外科學會期刊》的報告記錄了兩名兒童在使用大麻後，腦腫瘤殘餘部分自發性退縮的情況。[13]

另一篇於2018年發表的病例報告指出，一名五歲患者在使用合成CBD後，腦腫瘤的體積減少。研究人員指出：“2016年12月進行的掃描顯示腫瘤體積減少了約60％。隨後的掃描結果顯示疾病保持穩定，CBD是唯一的治療方式。”[14]

次年，巴西研究人員描述了兩名38歲腦癌患者使用CBD的情況。作者報告指出，患者在傳統抗癌治療的基礎上使用CBD，與臨床結果的“顯著改善”以及兩年內無疾病進展相關。研究人員總結道：“這些觀察結果特別引人注目，因為大麻素的藥理學似乎與現有的腫瘤學藥物不同，並可能為未來的膠質瘤治療提供一個獨特且可能具協同作用的選擇。”[15]

同年發表的一系列病例報告也描述了植物衍生的CBD在腦癌患者中的應用。研究人員報告指出，將400毫克CBD與標準抗癌療法聯合施用，在九名選定患者中的八名中，與預期的生存期相比，生存時間顯著延長。[16]

最近，一組澳大利亞研究人員評估了83名膠質瘤患者每日服用大麻提取物，這些提取物中含有1:1或4:1比例的THC與CBD。參與者在至少四週的時間內服用了這些提取物。研究人員得出結論：“這項研究提供了充分的證據，表明對這些患者群體使用藥用大麻是安全的，且能被良好耐受，並能為這些患者提供症狀緩解。……[它]表明，大麻，特別是1:1的CBD/THC混合物，對許多影響生活質量（QoL）症狀有幫助，尤其是睡眠障礙。因此，藥用大麻（MC）可能是這些預後不良群體維持最佳生活質量和日常功能的有價值的潛在療法，同時也能幫助患者在抗癌治療和可能延長生命的療法過程中。”[17]

除了大麻素在實驗室模型中對膠質瘤細胞的調節作用外，其他的前臨床研究也證明大麻素和內源性大麻素能抑制其他癌細胞系的增殖，[18-19] 包括乳腺癌，[20-24] 前列腺癌，[25-29] 結直腸癌，[30-31] 胃腺癌，[32] 皮膚癌，[33] 白血病細胞，[34-38] 神經母細胞瘤，[39-40] 肺癌，[41-42] 子宮癌，[43] 甲狀腺上皮癌，[44] 胰腺腺癌，[45-46] 宮頸癌，[47-48] 口腔癌，[49] 膽道癌（膽管癌）[50] 泌尿系癌症，[51] 以及淋巴瘤，[52-53] 等等。在某些情況下，當大麻素相互聯合使用時，報告顯示抗癌活性有所提高，而不是單獨使用時。[54-55] 2013年發表於《腫瘤學病例報告》期刊的一篇病例報告也報導了使用大麻提取物成功治療一名被診斷為急性淋巴細胞白血病的14歲患者的情況。[56] 人群研究還報告了大麻使用與多種癌症類型的患病率之間的反比關係，包括肺癌，[57] 頭頸癌，[58] 和膀胱癌。[59]

專家們承認，已有「可靠的科學證據支持大麻素在癌症的前臨床模型中表現出顯著的抗癌活性」[60]，並且大麻素或許有一天「能成為一類新的抗癌藥物，能夠減緩癌症生長，抑制血管生成以及癌細胞的轉移擴散」[61-62]。目前，藥用大麻在各類癌症患者中使用廣泛，儘管許多人表示他們「希望獲得，但未從腫瘤學醫療提供者那裡獲得有關治療過程中使用大麻的資訊」[63]。儘管缺乏大規模的臨床試驗，「大量的經驗性報告描述了患者在使用大麻作為抗癌藥物時有顯著的反應，特別是當以高效能的口服濃縮劑形式服用時……[因此]應進一步進行人類研究，以解答與前述效果相關的關鍵問題」[64]。

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原文標題：《Gliomas/Cancer》

原文作者：NORML

原始網站：https://norml.org

翻譯者：大麻101

翻譯日期：2025年4月

翻譯聲明：本文章由原文翻譯而來，原文發表於NORML。如需閱讀原文，請訪問 https://norml.org/marijuana/library/recent-medical-marijuana-research/gliomas-cancer/