脑转移作为预防和治疗的靶点。
Brain metastases as preventive and therapeutic targets.
机构信息
National Cancer Institute, Bethesda, MD 20892, USA.
出版信息
Nat Rev Cancer. 2011 May;11(5):352-63. doi: 10.1038/nrc3053. Epub 2011 Apr 7.
Abstract
The incidence of metastasis to the brain is apparently rising in cancer patients and threatens to limit the gains that have been made by new systemic treatments. The brain is considered a 'sanctuary site' as the blood-tumour barrier limits the ability of drugs to enter and kill tumour cells. Translational research examining metastasis to the brain needs to be multi-disciplinary, marrying advanced chemistry, blood-brain barrier pharmacokinetics, neurocognitive testing and radiation biology with metastasis biology, to develop and implement new clinical trial designs. Advances in the chemoprevention of brain metastases, the validation of tumour radiation sensitizers and the amelioration of cognitive deficits caused by whole-brain radiation therapy are discussed.
摘要
脑转移的发生率在癌症患者中显然呈上升趋势，这可能会限制新的全身治疗方法所取得的疗效。由于血脑屏障限制了药物进入并杀死肿瘤细胞的能力，因此大脑被认为是一个“避难所”。研究脑转移的转化研究需要多学科交叉，将先进的化学、血脑屏障药代动力学、神经认知测试和放射生物学与转移生物学相结合，以开发和实施新的临床试验设计。本文讨论了脑转移的化学预防、肿瘤辐射增敏剂的验证以及全脑放疗引起的认知缺陷的改善。
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