Chamberlain M C
Department of Neurology, Kaiser-Permanente, Baldwin Park, California 91706, USA.
Pediatr Neurol. 2001 Feb;24(2):117-21. doi: 10.1016/s0887-8994(00)00249-6.
Chronic oral VP-16 (etoposide) is a chemotherapy regimen with a wide application in oncology and documented efficacy against germ cell tumors, lymphomas, Kaposi's sarcoma, and primary brain tumors. This study was performed to assess the toxicity and activity of chronic oral etoposide in the management of children with recurrent intracranial nondisseminated ependymoma. Twelve children (median age of 8 years) with recurrent ependymoma who were refractory to surgery, radiotherapy, and chemotherapy (carboplatinum or the combination of procarbazine, lomustine, and vincristine) were treated with chronic oral etoposide (50 mg/m(2)/day). Treatment-related complications included the following: alopecia (10 children), diarrhea (6), weight loss (5), anemia (4), neutropenia (3), and thrombocytopenia (3). Three children required transfusion (two with packed red blood cells; two with platelets), and two children developed neutropenic fever. No treatment-related deaths occurred. Six children (50%) demonstrated either a radiographic response (two children, both with partial response) or stable disease (four children) with a median duration of response or stable disease of 7 months. In this small cohort of children with recurrent intracranial ependymoma, oral etoposide was well tolerated, produced modest toxicity, and had apparent activity.
长期口服依托泊苷（VP - 16）是一种化疗方案，在肿瘤学领域应用广泛，对生殖细胞肿瘤、淋巴瘤、卡波西肉瘤和原发性脑肿瘤的疗效已得到证实。本研究旨在评估长期口服依托泊苷治疗复发性颅内非播散性室管膜瘤患儿的毒性和活性。12例复发性室管膜瘤患儿（中位年龄8岁），对手术、放疗及化疗（卡铂或丙卡巴肼、洛莫司汀和长春新碱联合化疗）均耐药，接受长期口服依托泊苷（50mg/m²/天）治疗。治疗相关并发症如下：脱发（10例患儿）、腹泻（6例）、体重减轻（5例）、贫血（4例）、中性粒细胞减少（3例）和血小板减少（3例）。3例患儿需要输血（2例输浓缩红细胞；2例输血小板），2例患儿发生中性粒细胞减少性发热。未发生与治疗相关的死亡。6例患儿（50%）出现影像学反应（2例患儿，均为部分缓解）或疾病稳定（4例患儿），缓解或疾病稳定的中位持续时间为7个月。在这一小群复发性颅内室管膜瘤患儿中，口服依托泊苷耐受性良好，毒性较小，且具有明显活性。
