Giese A, Bock H C, Kantelhardt S R, Rohde V
Georg-August-University, Neurosurgery, Goettingen, Germany.
Cent Eur Neurosurg. 2010 Nov;71(4):199-206. doi: 10.1055/s-0029-1242775. Epub 2010 Jan 8.
Implantation of BCNU wafers (Gliadel®) into the resection cavity has demonstrated a survival benefit for patients with newly diagnosed malignant gliomas. The follow-up of two phase III trails has further shown that the number of long-term survivors was significantly increased by BCNU wafer treatment. BCNU wafer implantation may be integrated into current multimodal first line strategies. In the setting of recurrent disease BCNU wafer implantation has also shown a survival benefit and now extends the treatment options in a patient population that typically has undergone extensive pretreatment. An analysis of the literature has helped to clearly identify the risks associated with topic BCNU treatment. Here we summarize the incidence and time course of adverse events associated with local chemotherapy and propose solutions. The growing body of experience with BCNU wafer implantation may serve as a basis to develop adequate risk management strategies with regard to patient selection, surgical techniques, and follow-up schedules.
将卡莫司汀（Gliadel®）晶片植入切除腔已证明对新诊断的恶性胶质瘤患者有生存益处。两项III期试验的随访进一步表明，卡莫司汀晶片治疗显著增加了长期存活者的数量。卡莫司汀晶片植入可纳入当前的多模式一线治疗策略。在复发性疾病的情况下，卡莫司汀晶片植入也显示出有生存益处，并且现在为通常已经接受过广泛预处理的患者群体扩展了治疗选择。对文献的分析有助于明确识别与局部卡莫司汀治疗相关的风险。在此，我们总结与局部化疗相关的不良事件的发生率和时间进程，并提出解决方案。卡莫司汀晶片植入的经验不断积累，可为制定关于患者选择、手术技术和随访计划的适当风险管理策略提供依据。
