Packer R J
Department of Neurology, Children's National Medical Center, Washington, DC 20010.
Ann Neurol. 1990 Dec;28(6):823-8. doi: 10.1002/ana.410280615.
Chemotherapy has only marginal efficacy in adult malignant brain tumors. In contrast, drug therapy is considerably more effective in medulloblastoma/primitive neuroectodermal tumors (MB/PNET) of the posterior fossa, the most common childhood primary central nervous system tumor. At the time of disease recurrence, a variety of different single agents and drug combinations result in tumor shrinkage and increased survival. The addition of chemotherapy to standard radiotherapy improves the rate and length of disease-free survival for those children with MB/PNET who have the most extensive tumors at diagnosis. It remains to be determined which drug or drug combinations are the most effective in MB/PNET, and which patients are most likely to benefit from chemotherapy. Chemotherapy may be useful to reduce or, in selected cases, obviate the need for radiotherapy and reduce treatment-related sequelae.
化疗对成人恶性脑肿瘤的疗效甚微。相比之下，药物治疗在儿童后颅窝髓母细胞瘤/原始神经外胚层肿瘤（MB/PNET）中更为有效，这是儿童最常见的原发性中枢神经系统肿瘤。在疾病复发时，多种不同的单一药物和药物组合可导致肿瘤缩小并延长生存期。对于诊断时肿瘤范围最广的MB/PNET儿童患者，在标准放疗中加入化疗可提高无病生存率的比率和时长。目前仍有待确定哪种药物或药物组合在MB/PNET中最有效，以及哪些患者最有可能从化疗中获益。化疗可能有助于减少或在某些情况下避免放疗的必要性，并减少与治疗相关的后遗症。
