Bouffet E, Khelfaoui F, Philip I, Biron P, Brunat-Mentigny M, Philip T
Pediatric Department, Centre Léon Bérard, Lyon, France.
Cancer Chemother Pharmacol. 1997;39(4):376-9. doi: 10.1007/s002800050586.
Carmustine (BCNU) has proved to be of value against a variety of primary brain tumors. This agent exhibits a steep dose-response curve in in vitro and animal tumor models and has been proposed for use in high-dose chemotherapy as a single agent or in combination. We conducted a phase II study to assess high-dose BCNU in children with high-grade gliomas. A total of 13 children with high-grade gliomas were treated in a phase II study using high-dose BCNU (800 mg/m2) followed by autologous bone marrow transplantation. Eight patients were newly diagnosed, and five were treated at the time of tumor recurrence. Seven patients had diffuse intrinsic brain-stem gliomas. The response was assessed at 1 month after treatment. Only one objective effect was observed. Five patients had stable disease and seven progressed. The immediate toxicity was mild; however, one patient developed fatal respiratory distress at 50 days after treatment with high-dose BCNU. Dose escalation of BCNU does not seem beneficial in children with high-grade gliomas.
卡莫司汀（BCNU）已被证明对多种原发性脑肿瘤有治疗价值。在体外和动物肿瘤模型中，该药物呈现出陡峭的剂量反应曲线，并已被提议用于大剂量化疗，可单独使用或联合使用。我们进行了一项II期研究，以评估大剂量BCNU对高级别胶质瘤儿童的疗效。在一项II期研究中，共有13名高级别胶质瘤儿童接受了大剂量BCNU（800 mg/m²）治疗，随后进行自体骨髓移植。8例为新诊断患者，5例在肿瘤复发时接受治疗。7例患有弥漫性脑桥内在型胶质瘤。在治疗后1个月评估疗效。仅观察到1例客观疗效。5例病情稳定，7例病情进展。近期毒性较轻；然而，1例患者在接受大剂量BCNU治疗50天后出现致命的呼吸窘迫。对于高级别胶质瘤儿童，BCNU剂量递增似乎并无益处。
