Batchelor Tracy, Rodon Jordi, Ahluwalia Manmeet
Department of Neurology, Harvard Medical School and Catherine Pappas Center for Neuro-Oncology, Massachusetts General Hospital, Boston, MA, USA.
Vall D'Hebron Institute of Oncology and Universitat Autonoma de Barcelona, Barcelona, Spain.
Handb Clin Neurol. 2016;134:149-62. doi: 10.1016/B978-0-12-802997-8.00009-8.
This chapter will review the challenges in pharmacotherapy in primary brain tumors that include the presence of the blood-brain barrier, a blood-tumor barrier, active drug efflux pumps, and high plasma protein binding of agents. The approaches to improve the delivery of drugs to the brain will be discussed. Often the management of brain tumors involves the use of corticosteroids and enzyme-inducing antiseizure medications that can have significant drug interactions that may impact the efficacy or toxicity of drugs used to treat these patients. Various techniques used to assess drug distribution to the brain will be reviewed.
本章将综述原发性脑肿瘤药物治疗中所面临的挑战，这些挑战包括血脑屏障、血瘤屏障的存在、活性药物外排泵以及药物的高血浆蛋白结合率。还将讨论改善药物向脑部递送的方法。脑肿瘤的治疗通常涉及使用皮质类固醇和酶诱导抗癫痫药物，这些药物可能会产生显著的药物相互作用，从而影响用于治疗这些患者的药物的疗效或毒性。将综述用于评估药物在脑部分布的各种技术。
