Hospital de Cruces, Barakaldo, Guipúzcoa, Spain.
Clin Transl Oncol. 2012 Apr;14(4):280-6. doi: 10.1007/s12094-012-0796-0.
To assess the efficacy and safety of liposomal cytarabine in the treatment of de novo and relapsed leptomeningeal involvement in children with primary CNS tumours.
Data from clinical charts were entered into a database for consecutive unselected patients (n=20) from nine Spanish centres. Diagnosis of leptomeningeal involvement was confirmed by cytology, MRI and/or CT scan. The dose of liposomal cytarabine used varied from 20 to 50 mg, by age.
There were 8 females and 12 males, mean age 7.3 years (range 8 months to 18 years). The tumours were: 10 medulloblastomas, 4 ependymomas, 3 primitive neuroectodermal tumours and 3 other tumours. Fourteen had undergone previous chemotherapy and 12 radiotherapy. Nine received concurrent chemotherapy and 2 concurrent radiotherapy. Median follow-up was 244.5 days (range 12- 869). Patients received a median of 5 doses (range 1-9) of liposomal cytarabine. A neurological response (complete or partial) was seen in 11/19 (58%) and a cytological response in 7/10 (64%). Median time to neurological progression exceeded 180 days (range 12-869). Adverse effects were reported in 11/20 patients, but none was grade IV.
Liposomal cytarabine was well tolerated and efficacious in this patient group, but prospective randomised trials are needed.
评估脂质体阿糖胞苷治疗儿童原发性中枢神经系统肿瘤新发和复发的软脑膜浸润的疗效和安全性。
从 9 个西班牙中心的连续未选择患者（n=20）的病历中录入数据到数据库中。软脑膜浸润的诊断通过细胞学、MRI 和/或 CT 扫描确认。脂质体阿糖胞苷的剂量根据年龄从 20 至 50mg 不等。
有 8 名女性和 12 名男性，平均年龄为 7.3 岁（8 个月至 18 岁）。肿瘤类型为：10 例髓母细胞瘤、4 例室管膜瘤、3 例原始神经外胚层肿瘤和 3 例其他肿瘤。14 例患者曾接受过化疗，12 例接受过放疗。9 例患者接受了同步化疗，2 例患者接受了同步放疗。中位随访时间为 244.5 天（12-869 天）。患者接受了中位数为 5 个剂量（1-9 个）的脂质体阿糖胞苷治疗。19 例中有 11 例（58%）出现了神经学反应（完全或部分），10 例中有 7 例（64%）出现了细胞学反应。神经进展的中位时间超过 180 天（12-869 天）。20 例患者中有 11 例出现了不良反应，但均无 4 级不良反应。
脂质体阿糖胞苷在该患者群体中耐受性良好且有效，但需要进行前瞻性随机试验。
