Pollack I F, Boyett J M, Finlay J L
Department of Neurosurgery, Children's Hospital of Pittsburgh, University of Pittsburgh Medical School, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA.
Childs Nerv Syst. 1999 Oct;15(10):529-44. doi: 10.1007/s003810050541.
Astrocytomas are the most common group of childhood brain tumors. Approximately 20% of these lesions are histologically malignant tumors that often prove fatal within 2 years of diagnosis, despite the use of surgery and conventional radiotherapy. During the last 15 years, considerable attention has been focused on evaluating the potential role of chemotherapy as a means of improving survival. Although several agents have been observed to have modest therapeutic activity against these tumors, the optimal strategies for improving disease control have yet to be defined. This article will review the results that have been achieved in previous studies using a variety of single and multi-agent chemotherapeutic regimens, and also the rationale for ongoing trials of the major cooperative groups, and will discuss the challenges that are inherent in designing and interpreting therapeutic studies for these tumors. Ways in which currently available approaches may be incorporated into future therapeutic strategies will also be discussed and a brief review of the extensive array of promising new treatment approaches will be presented.
星形细胞瘤是儿童期最常见的脑肿瘤类型。这些病变中约20%为组织学上的恶性肿瘤，尽管采用了手术和传统放疗，但通常在诊断后2年内就会致命。在过去15年中，相当多的注意力集中在评估化疗作为提高生存率手段的潜在作用上。尽管已观察到几种药物对这些肿瘤有一定的治疗活性，但改善疾病控制的最佳策略尚未确定。本文将回顾以往使用各种单药和多药化疗方案的研究成果，以及主要协作组正在进行试验的理论依据，并将讨论在设计和解释这些肿瘤的治疗研究中固有的挑战。还将讨论如何将目前可用的方法纳入未来的治疗策略，并简要回顾一系列有前景的新治疗方法。
