Prados M D, Russo C
Department of Neurosurgery, University of California, San Francisco 94117, USA.
Semin Surg Oncol. 1998 Jan-Feb;14(1):88-95. doi: 10.1002/(sici)1098-2388(199801/02)14:1<88::aid-ssu11>3.0.co;2-5.
For many years, chemotherapy has been utilized for the treatment of malignant brain tumors with minimal success. This particularly true with chemotherapy in adult malignant gliomas for which no new drug has been approved for use since the initial studies using nitrosoureas and procarbazine in the early 1960s. However, the results of more recent clinical trials research using newer agents appear to show improved outcome in some tumor types. Better understanding of the basic biology of these diverse tumors also have given rise to new treatment strategies, especially to drug development. A large number of new antineoplastic agents are now being tested in Phase I and II trials; they are very promising and soon may lead to new drug approvals. This review will discuss the results of completed trials for newly diagnosed and recurrent glioma in adults, as well as ongoing, new drug studies with these patients. A discussion of the more common pediatric brain tumors and the use of chemotherapy in that age group is also presented. Chemotherapy is often the primary treatment modality used to control tumor growth in newly diagnosed infants and young children, and it is in this setting that chemotherapy is particularly beneficial in reducing morbidity and increasing survival. As part of a multimodality approach that includes surgery and radiotherapy, chemotherapy has a significant role to play in the treatment of both adults and children with brain neoplasms.
多年来，化疗一直被用于治疗恶性脑肿瘤，但收效甚微。在成人恶性胶质瘤的化疗中尤其如此，自20世纪60年代初首次使用亚硝基脲和丙卡巴肼进行研究以来，尚无新药获批用于治疗成人恶性胶质瘤。然而，最近使用新型药物进行的临床试验研究结果似乎表明，在某些肿瘤类型中，治疗效果有所改善。对这些不同肿瘤基本生物学的更深入了解也催生了新的治疗策略，尤其是药物研发。大量新型抗肿瘤药物目前正在进行I期和II期试验；它们前景广阔，可能很快会带来新药获批。本综述将讨论成人新诊断和复发性胶质瘤已完成试验的结果，以及针对这些患者正在进行的新药研究。还将讨论更常见的儿童脑肿瘤以及该年龄组化疗的应用。化疗通常是用于控制新诊断的婴幼儿肿瘤生长的主要治疗方式，正是在这种情况下，化疗在降低发病率和提高生存率方面特别有益。作为包括手术和放疗在内的多模式治疗方法的一部分，化疗在治疗成人和儿童脑肿瘤方面都发挥着重要作用。
