de la Fuente B Pilo, Dalmau J, Rosenfeld M
Servicio de Neurología, Hospital Ramón y Cajal, Madrid, Spain.
Neurologia. 2007 Apr;22(3):159-69.
The prognosis for patients with malignant brain tumors has always been poor and until recently chemotherapy had not shown to be very effective. Temozolomide is a novel second-generation alkylating agent that has shown efficacy for the treatment of high-grade gliomas. Temozolomide is well-tolerated by most patients and has favorable pharmacodynamic and pharmacokinetic properties. In patients with newly diagnosed glioblastoma multiforme, radiation therapy with concurrent and adjuvant temozolomide significantly improves overall survival compared to treatment with only radiation. The benefit of temozolomide is greatest in patients with tumors that have a methylated 06-methyl-guanine DNA methyl transferase gene promoter that results in decreased repair of temozolomide-induced DNA damage. This chapter will briefly review the diagnosis and treatment of patients with malignant brain tumors and then will focus on the role of temozolomide in glioma therapy.
恶性脑肿瘤患者的预后一直很差，直到最近，化疗都未显示出显著疗效。替莫唑胺是一种新型的第二代烷化剂，已显示出对高级别胶质瘤的治疗效果。大多数患者对替莫唑胺耐受性良好，且具有良好的药效学和药代动力学特性。在新诊断的多形性胶质母细胞瘤患者中，与单纯放疗相比，同步放化疗联合辅助替莫唑胺治疗可显著提高总生存率。替莫唑胺对肿瘤06-甲基鸟嘌呤-DNA甲基转移酶基因启动子发生甲基化的患者益处最大，这种甲基化会导致替莫唑胺诱导的DNA损伤修复减少。本章将简要回顾恶性脑肿瘤患者的诊断和治疗，然后重点讨论替莫唑胺在胶质瘤治疗中的作用。
