O'Reilly S M, Newlands E S, Glaser M G, Brampton M, Rice-Edwards J M, Illingworth R D, Richards P G, Kennard C, Colquhoun I R, Lewis P
Department of Medical Oncology, Charing Cross Hospital, London, U.K.
Eur J Cancer. 1993;29A(7):940-2. doi: 10.1016/s0959-8049(05)80198-4.
Temozolomide, a new oral cytotoxic agent, has been given to 28 patients with primary brain tumours. Treatment was given at a dose of 150 mg/m2/day for 5 days (i.e. total dose 750 mg/m2) escalating, if no significant myelosuppression was noted on day 22, to 200 mg/m2/day for 5 days (i.e. total dose 1000 mg/m2) for subsequent courses at 4 week intervals. A major improvement in computer tomography (CT) scan was noted in 5/10 patients with astrocytomas recurrent after radiotherapy, with a major clinical improvement but minor improvement on CT scan in one further patient. Reduction in the size of the CT lesion was also observed in 4/7 patients with newly diagnosed high grade astrocytomas given 2-3 courses of temozolomide prior to irradiation. 1 patient with recurrent medulloblastoma had a clinical response in bone metastases. Temozolomide was well tolerated with little subjective toxicity and usually predictable myelosuppression and is a promising new drug in the treatment of primary brain tumours.
替莫唑胺是一种新型口服细胞毒性药物，已应用于28例原发性脑肿瘤患者。治疗剂量为150mg/m²/天，连用5天（即总剂量750mg/m²），如果在第22天未发现明显的骨髓抑制，则后续疗程剂量递增至200mg/m²/天，连用5天（即总剂量1000mg/m²），每4周进行一个疗程。在10例放疗后复发的星形细胞瘤患者中，5例计算机断层扫描（CT）有显著改善，另有1例患者临床有显著改善，但CT扫描仅有轻微改善。在7例新诊断的高级别星形细胞瘤患者中，4例在放疗前接受2 - 3个疗程替莫唑胺治疗后，CT上的病灶大小缩小。1例复发性髓母细胞瘤患者骨转移有临床反应。替莫唑胺耐受性良好，主观毒性小，骨髓抑制通常可预测，是治疗原发性脑肿瘤的一种有前景的新药。
