Newton H B, Slivka M A, Stevens C
Department of Neurology, The Ohio State University Medical Center & James Cancer Hospital and Solove Research Institute, Columbus, USA.
J Neurooncol. 2000 Sep;49(2):165-70. doi: 10.1023/a:1026770624783.
Meningiomas represent 18-20% of all intracranial tumors and have a 10-year recurrence rate of 20-50%, despite aggressive surgery and irradiation. In addition, many tumors are not amenable to surgery due to their deep location or proximity to delicate structures. Chemotherapy is being explored as another potential treatment option for unresectable or refractory meningiomas. Hydroxyurea is an agent that inhibits ribonucleotide reductase and can induce apoptosis in meningioma cell cultures and animal models. We have placed 17 patients with unresectable or residual meningioma on hydroxyurea chemotherapy (20 mg/kg/d orally). The mean age of our cohort was 57.2 years; 13 patients were female. Eleven patients had actively growing tumors or neurological progression at the onset of chemotherapy. Sixteen patients were evaluable for response. Fourteen of the 16 patients (88%) responded with stable disease ranging from 20 to 144+ weeks (median 80 weeks; 10 patients still accruing time). Three of the responders progressed after 20, 36, and 56 weeks, respectively. Two patients had progressive disease after 10 weeks. Toxicity was hematologic in most patients; leukopenia was most common. Nine patients (53%) required dosage reductions (250-500 mg/d) secondary to hematologic toxicity. Hydroxyurea appears to have modest activity against meningiomas and should be considered in patients with unresectable tumors or large residual tumors following surgical resection.
脑膜瘤占所有颅内肿瘤的18 - 20%，尽管采取了积极的手术和放疗，其10年复发率仍为20 - 50%。此外，许多肿瘤由于位置深或靠近精细结构而无法进行手术。化疗正被探索作为不可切除或难治性脑膜瘤的另一种潜在治疗选择。羟基脲是一种抑制核糖核苷酸还原酶的药物，可在脑膜瘤细胞培养物和动物模型中诱导细胞凋亡。我们对17例不可切除或残留脑膜瘤患者进行了羟基脲化疗（口服20mg/kg/d）。我们队列的平均年龄为57.2岁；13例为女性。11例患者在化疗开始时肿瘤呈活跃生长或有神经功能进展。16例患者可评估反应。16例患者中有14例（88%）反应为病情稳定，持续时间为20至144 +周（中位数80周；10例患者仍在累计时间）。3例反应者分别在20、36和56周后病情进展。2例患者在10周后病情进展。大多数患者的毒性为血液学毒性；白细胞减少最为常见。9例患者（53%）因血液学毒性需要减少剂量（250 - 500mg/d）。羟基脲似乎对脑膜瘤有一定活性，对于不可切除肿瘤或手术切除后有大的残留肿瘤的患者应考虑使用。
