[2011.06.09] 癌症治疗即将实现对症下药

引用 vegeLisa 2011-6-14 22:10

大赞一个！
指出点小瑕疵：
倒数第二段最后一句没翻译出来，估计是漏了~~
personalized译为“个体化”比较合适~~

引用 tchch143 2011-6-14 22:26

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提的非常正确，多谢了

引用 vicent1986 2011-6-15 08:32

这篇文章所涉及的领域主要阐述的是个性化医疗，因此用个体化不如用个性化更贴切

引用 re.jet 2011-6-24 19:57

本帖最后由 re.jet 于 2011-6-24 21:33 编辑

1.personalise在临床医学一块，“个体化”是通行的、标准的、稳定的翻译了。
2.personalised medicine，这个，我推荐修改为“个体化用药”。是比较稳定的用语，也比较准确。
3.chronic myelogenous leukaemia，简写是CML，还有一个“慢性粒细胞白血病”。使用AML和ALL的话，AML翻译成“慢性粒细胞白血病”比较流行，但似乎没有那个更专业。
4.所展现出的治疗效果令世人瞩目：展现出了令人瞩目的治疗效果。世人瞩目有点夸张了。
5.而在癌症的大多数病例中：而在大多数的癌症病例中——我是CHN，不是AME。
6. phase I trials：第一阶段试验，这个就是CCTV常讲的临床1期实验，后面就是2期3期了。
7.original site，初始位置，这个，我倾向于“原发灶”。其实和前面的“where in the body a tumour has sprung up”采用了同样一个道理。
8.will probably prove fatal：他们也将因此而有性命之忧。我理解的主语是“tumour ”。具有远处扩散是恶性肿瘤的一个特征。恶性肿瘤通常理解是“fatal”的。我对整个句子的理解：这些实验的参与者通常是患有那些会被证明很可能是具有致命性的，已经扩散超出了原发灶肿瘤的病人。
9.to no avail，却徒劳无功：却并无疗效。不耍空腔。
10.Their precarious condition means they are rarely accepted for phase II and III trials, which are more complicated and extensive.
我的理解是：他们危重的（precarious ，临床好像有更好的词，一下跟不上了，极度衰弱？“衰竭”又有个专门的词，使不上了。）身体状况也就意味着，只有极少的人能够接受更为复杂和强烈的临床2期和3期试验（身体太糟糕了，2期和3期又复杂又密集，他们那身体状况，极少数人能受得了。太……而不能……了。化疗药是个精细的药，护士配药也要戴手套，药水渗出血管外的话，有时候反应也比较严重，不只是肿个大包包。是个很烈性的药）
11.respond successfully to the treatment.治疗后病情大有起色：对于治疗反应良好。癌症化疗，比如肿瘤灶缩小，比如指标上的变化，都可以叫做respond，就怕药下去了，癌症没变化，没动静，化疗不敏感，多化疗几次，化疗药就耐药，药效往下掉，（备用下20.）。successfully 对应成良好，我觉得比较实在。
12.approach ：疗法？手术进路、手术入路？new approach：新疗法。
13.responded positively，疗效显著。successfully 对应成良好，我觉得比较实在。positively，有着正向反应，积极的反应，就够了。
14.improvements，好转：改善。病情改善。得了癌症，一般不能好转，只是改善，改善，就像社会主义不断改革，改革，但就是不革命，绝不革命。
15.经过、产生有效反应的时间、存活时间：进行、发生反应、生存期。最后这个生存期有个专业术语，这里不用也许更好。但进行治疗，对药发生反应，这个主被动的语法逻辑的应该可以探讨。
16.qualified，修正。这个不太妥帖。可惜我对临床试验不太懂。检验？校验？检验比较合适。数据是有了，数据质量怎样，那就要检验。
17.gold standard：黄金法则。同1，金标准。有过“黄金法则”，“金标准”是通行的、标准的、稳定的翻译了。
18.可能导致了不同的结果：导致了结果上的不同。
19. higher，偏高，这里让同志们不好理解是比正常人高，还是比另一组高。我理解的是，比另外一组高。更高。
20.然而那些进行靶向治疗的人比他们先前治疗时的效果更好，而那些未进行靶向治疗的人和先前治疗时相比没有变化。those who were not，我觉得是： not did better，不是没有变化。整个句子，我的理解是：即便如此，与对先期治疗的反应进行比较的话，进行靶向治疗的表现更好，而没有进行靶向治疗就没有这回事了。
21. robust response：反应良好.robust 在我心里是个很强悍的形容词，大约相当于施瓦辛格那样吧，我情绪上觉得可以试试用：反应强劲。
22.sample ：取样，还是提取标本实在。
23.invasive，侵入性。MIS：微创手术
24.这种方式与直接法相比在精确性上几乎相同：这种方式的精确性与直接法相比几乎相同。OR：在精确性上，与直接法相比这种方式几乎一致——我是CHN，不是AME。
25.confirmed：确证。得到证实。我就喜欢实在，更实在一点。
26.我早就看上了这篇，但翻译不来。只好……。
   多多包涵，周末愉快，相互学习，共同进步~

引用 tchch143 2011-6-26 21:50

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提出的意见都非常在行，谨表感谢，因为时间仓促，找时间回复，还望见谅。

引用 laoyetu02 2011-7-1 10:06

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楼主译得不错，我也自己译了一下，有些地方想与楼主交流交流。

1 That is starting to happen in the field of cancer.
蓝色字体部分我觉得用现在进行时更贴切些。
试译：这种做法正开始为癌症领域所使用。

2Yet in most cases of cancer doctors still base their treatment on where in the body a tumour has sprung up, rather than on which molecular aberrations have caused it.
个人愚见，
试译：然而，在大多数的癌症病例中，医生仍将治疗的根本放在体内肿瘤突起处，而非放在诱发肿瘤的分子畸变上。

3 On average, fewer than 5% of participants in phase I trials respond successfully to the treatment.
respond...to... 牛津高阶字典上的解释为有改进；见起色；显出效果。里面有这么一个例句：“The infection did not respond to the drugs. 这些药物对感染没有起作用。”
试译：在试验1期中，治疗只对平均不到5%的被试非常有效。

4 If these preliminary results are confirmed, more patients with advanced cancer will have been offered a tantalising glimmer of hope.
tantalize做动词用是指：to make a person or an animal wnat sth. that they cannnot have or do
用作形容词，我觉得有“让人向往”之意，a tantalising glimmer of hope 我把它处理为 一丝曙光，“曙光”有让人向往的意境在里面。
试译：如果这些初始结果得到证实，这将为更多的晚期癌症患者带来一丝曙光。

引用 laoyetu02 2011-7-1 10:08

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另附上自己译的，献丑了。


Cancer therapy
癌症治疗
Taking aim sooner
即将对症下药（楼主标题译得很好，我借用了，呵）
If personalised medicine is to achieve its full potential, it should be used earlier on in clinical trials
如果进行个体化治疗是为了充分发挥其潜能，那么应将它尽早用于临床试验
Jun 9th 2011 | from the print edition

ONE of the prospects supporters of the Human Genome Project held out was personalised medicine. Knowing which genes were involved in a particular patient’s disease would allow drugs to be deployed with greater precision. That is starting to happen in the field of cancer. Several targeted therapies, aimed at specific cancer-causing mutations, including Gleevec for chronic myelogenous leukaemia and Herceptin for some types of breast cancer, have been spectacularly successful. Yet in most cases of cancer doctors still base their treatment on where in the body a tumour has sprung up, rather than on which molecular aberrations have caused it.
人类基因组计划支持者认为其前景之一便是个体化治疗。知晓哪种基因是患者致病的原因，用药就够更加准确。这种做法正开始为癌症领域所使用。而针对特定致癌基因突变的几项靶向治疗———如治疗慢性粒细胞性白血病的格列卫（Gleevec）以及治疗几种乳癌的赫赛汀（Herceptin）——已经取得了显著的疗效。然而，在大多数的癌症病例中，医生仍将治疗的根本放在体内肿瘤突起处，而非放在诱发肿瘤的分子畸变上。
The same is true of medical researchers recruiting volunteers for clinical trials, especially those known as phase I trials, in which a new drug is tested on people for the first time. Participants in such trials are often those whose tumour has spread beyond its original site, and will probably prove fatal. Usually, they have tried all proven therapies, to no avail. Their precarious condition means they are rarely accepted for phase II and III trials, which are more complicated and extensive.
而那些招募临床试验被试的医学研究员也同样如此，特别是在将新药首次用于人体试验的第一期。通常这种试验的被试其体内的肿瘤已经扩散到原发灶之外，且有可能被证实是致命的。通常，被试已经试过所有的已证实疗法，但都无济于事。羸弱的身体状况意味着他们不常接受2期及3期试验，而这两个阶段的试验要更复杂，也更密集。
Oddly, though, even if the drug being tested is a targeted therapy the tradition in phase I trials has been to gather together patients with, say, lung cancer and assume that all carry the relevant mutation. That is  because such trials are concerned mainly with testing a drug’s safety, not its efficacy. The volunteers are usually happy to go along with this. But the odds are not good. On average, fewer than 5% of participants in phase I trials respond successfully to the treatment.
奇怪的是，尽管用于测试的药物是靶向治疗药物，但试验1期的常规做法是将病人，如肺癌患者，归到一块儿，并假定他们体内都携带了相关的基因突变。因为这样的试验主要涉及药物的安全性，而非有效性。通常被试很赞同注重安全性这一点。但试验的成功率却并不乐观。在试验1期中，治疗只对平均不到5%的被试非常有效。
Many scientists think this approach is a wasted opportunity. They believe that matching volunteers’ genetic profiles to the drugs being tested will not only be better for the volunteers, but may also speed up the trials, and save millions of dollars in the process. One such is Apostolia-Maria Tsimberidou of the University of Texas’s MD Anderson Cancer Centre, in Houston. And her preliminary results, presented this week at a meeting of the American Society of Clinical Oncology in Chicago, suggest she is right.
许多科学家觉得这样做是白忙活。他们认为将被试的基因图谱与用于测试的药物配对不仅对被试有好处，而且还能加快实验进程，节省数百万美元的经费。其中一位科学家便是位于休斯敦得克萨斯大学医学博士安德森癌症中心的阿波斯托利亚—玛丽亚•Tsimberidou（Apostolia-Maria Tsimberidou）。而初步结果显示她的想法是对的。该结果于美国临床肿瘤学会本周在芝加哥召开的会议上公布。
On target?
对症？
Dr Tsimberidou and her colleagues selected volunteers with late-stage cancer whose tumours were caused by single, known mutations and did the equivalent of a phase I trial on them. In the case of the 175 volunteers for whose mutations a targeted therapy existed, it was given. The remaining 116 received traditional treatment. Of those in the targeted-trial group, 29% responded positively to the therapy. (The tumours of four disappeared altogether.) Only 5% of those on untargeted drugs showed improvements—precisely in line with the historical figure. Those on targeted drugs also responded for longer than those who were not (five months, as against two months, on average). And they lived for 13 months compared with nine.
Tsimberidou博士和她的同事挑选了那些体内肿瘤因单一及已知基因突变而诱发，处于癌症晚期的被试，并对他们进行了相当于第1期的试验。175名用靶向疗法治疗基因突变的被试接受了这项试验。剩下的116名被试则接受传统治疗。在接受靶向治疗的被试中，29%的人疗效明显。（四名被试体内的肿瘤完全消失。）而接受传统治疗的被试中，只有5%的人病情有所改善——这正好与以往的数据相吻合。那些使用靶向药物治疗的人要比没有使用的人疗效长（平均为前者5个月，后者2个月）。前者活了13个月，而后者活了9个月。
Dr Tsimberidou cautions that the data, though encouraging, need to be qualified. Since her patients were not assigned to the targeted and untargeted groups at random, the gold standard for clinical trials, some hidden variable, rather than the treatment, may explain the different outcomes. The untargeted group might, for example, have been sicker to start with. They did, indeed, have higher initial levels of lactate dehydrogenase, an enzyme associated with tissue breakdown, so this possibility should not be discounted. However, those on targeted therapy did better, compared with their reactions to previous treatments, than those who were not.
Tsimberidou博士提醒到，尽管那项数据比较乐观，但是仍需要限制。由于她的病人并不是被随机分到靶向治疗组和非靶向治疗组，所以临床试验的黄金标准，即一些隐含变量，而非治疗本身可解释结果上的不同。比如，非靶向治疗组的被试一开始就病得要重些。他们乳酸脱氢酶（与组织分解有关的一种酶）的初始浓度的确要高一些，所以应该将这样的可能性考虑在内。然而，与先前治疗的效果相比较，那些接受靶向治疗的被试要比没有接受靶向治疗的被试情况好一些。
Not surprisingly, drug companies are taking an interest in the findings. If a hefty proportion of patients in an early trial show a robust response to a drug, its developer may be able to skip phase II, the first real look at a drug’s pharmacological credentials, and jump straight to a phase III trial—the ultimate test of efficacy. This might save a company several years of clinical studies, and an awful lot of money.
不足为奇的是制药公司正对这一结果很感兴趣。要是早期试验显示药物对大部分患者有强劲的作用，公司开发商就有可能跳过试验2期，即，对药物药理凭据的首次真正探寻，然后直接进入试验3期——效度最终测试。这样做可以让公司节省好几年临床研究的时间以及一大笔经费开销。
Widespread adoption of the new approach may, however, be difficult. Tests to detect cancer-causing mutations are still in their infancy. Many such mutations have not yet been identified, and even when a known mutation is found in a tumour, drugs to block its effects may be unavailable. On top of that, many patients will not participate in a trial that requires the collection of an additional sample from their tumour, for this is an invasive, painful and potentially dangerous procedure. Indeed, one in ten of the applicants for Dr Tsimberidou’s trial was unable to provide samples which could be tested for their molecular make-up.
不过，要广泛采用这种新疗法可能会有困难。用于查明致癌基因突变的测试仍在初始阶段。许多这样的基因突变还未被确认，即便在肿瘤中找到了一个已知的基因突变，但对其起抑制作用的药物也可能还未研制出。除此之外，许多患者不会参加要求额外提取其肿瘤样本的试验，因为这样做很痛苦，会有扩散的危险以及潜在的危害。实际上，Tsimberidou博士的试验中有1/10的被试无法提供可以检测他们分子组织的样本。
However, Johann de Bono and his colleagues at the Royal Marsden Hospital, in London, think that they have found a solution to this problem. Rather than probe tumours directly, they can test bits of tumour DNA that float in the bloodstream, and identify genetic mutations in this way with nearly the same accuracy as the direct method provides. If these preliminary results are confirmed, more patients with advanced cancer will have been offered a tantalising glimmer of hope.
然而，伦敦皇家马斯登医院的约翰•德•博诺（Johann de Bono）以及他的同事认为他们已经找到了解决问题的方法。他们没有直接探测肿瘤，而是检测漂浮在血液里的一些肿瘤DNA，并通过几乎与直接法提供的同样精确的方法确认基因突变。如果这些初始结果得到证实，这将为更多的晚期癌症患者带来一线希望。

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