Schreck Karisa C, Grossman Stuart A
Oncology (Williston Park). 2018 Nov 15;32(11):555-60, 569.
Temozolomide has been available to oncologists for over 30 years. During this time, it has become an integral part of standard therapy in patients with high-grade gliomas. Given its ability to traverse the blood-brain barrier, temozolomide has also been evaluated in other cancers that involve the central nervous system (CNS). We review its role in the management of patients with primary brain tumors, brain metastases, leptomeningeal carcinomatosis, and other selected CNS cancers. There is strong evidence that temozolomide is effective in patients with high-grade astrocytomas and oligodendrogliomas. Modest evidence supports its activity in primary CNS lymphomas and aggressive pituitary adenomas. Temozolomide, however, has minimal efficacy in a wide variety of systemic cancers. Given that concentrations of temozolomide in the CNS are only 20% of those in the blood, it is not surprising that it is generally inactive in patients with CNS metastases from solid tumors.
替莫唑胺已供肿瘤学家使用超过30年。在此期间，它已成为高级别胶质瘤患者标准治疗中不可或缺的一部分。鉴于其穿越血脑屏障的能力，替莫唑胺也已在其他累及中枢神经系统（CNS）的癌症中进行了评估。我们回顾其在原发性脑肿瘤、脑转移瘤、软脑膜癌病及其他特定CNS癌症患者管理中的作用。有强有力的证据表明替莫唑胺对高级别星形细胞瘤和少突胶质细胞瘤患者有效。有适度的证据支持其在原发性CNS淋巴瘤和侵袭性垂体腺瘤中的活性。然而，替莫唑胺在多种全身性癌症中的疗效甚微。鉴于CNS中替莫唑胺的浓度仅为血液中的20%，它在实体瘤脑转移患者中通常无活性也就不足为奇了。
