Chemotherapeutic dose intensification for treatment of malignant brain tumors: Recent developments and future directions

被引：29
作者：
Kraemer D.F. [1 ]
Fortin D. [1 ]
Neuwelt E.A. [1 ]
机构：
[1] Departments of Neurology and Neurosurgery, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, 97201, OR
来源：
Current Neurology and Neuroscience Reports | 2002年 / 2卷 / 3期
关键词：
Cytosine Deaminase; Historic Control Patient; Increase Dose Intensity; Malignant Brain Tumor; Stem Cell Rescue;
D O I：
10.1007/s11910-002-0080-8
中图分类号：
学科分类号：
摘要：
Despite a large amount of research on malignant brain tumors over the past 70 years, the prognosis for most tumor types is poor. One current focus of research is increasing dose intensity of chemotherapeutic agents. Various ways to increase dose intensity include high-dose chemotherapy followed by stem cell rescue (eg, bone marrow transplant), blood-brain barrier disruption or use of RMP7 to increase transvascular drug delivery, local delivery of chemotherapeutic agents (convection enhancement or clysis, antibody conjugates, and biodegradable polymers), chemoprotective agents, and tumor sensitizers. Improved identification of patients likely to respond to a given regimen may also increase the effectiveness of chemotherapy. We also discuss approaches to improve the design of nonrandomized trials by identifying and controlling potential confounding variables. This will improve the quality of individual studies and perhaps the comparability across studies. © 2002, Current Science Inc.
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页码：216 / 224
页数：8
相关论文
共 79 条
[1]  
DeAngelis L.M., Medical progress: brain tumors, N Engl J Med, 344, pp. 114-123, (2001)
[2]  
Doolittle N.D., Muldoon L.L., Brummett R.E., Et al., Delayed sodium thiosulfate as an otoprotectant agent against carboplatin-induced hearing loss in patients with malignant brain tumors, Clin Cancer Res, 7, pp. 493-500, (2001)
[3]  
McAllister L.D., Doolittle N.D., Guastadisegni P.E., Et al., Cognitive outcomes and long-term follow-up results after enhanced chemotherapy delivery for primary central nervous system lymphoma, Neurosurgery, 46, pp. 51-61, (2000)
[4]  
Kroll R.A., Neuwelt E.A., Outwitting the blood-brain barrier for therapeutic purposes: osmotic opening and other means, Neurosurgery, 42, pp. 1083-1100, (1998)
[5]  
Keshelava N., Seeger R.C., Groshen S., Reynolds C.P., Drug resistance patterns of human neuroblastoma cell lines derived from patients at different phases of therapy, Cancer Res, 58, pp. 5396-5405, (1998)
[6]  
Fortin D., Neuwelt E.A., Therapeutic manipulation of the blood brain-barrier, Neurology Medlink, Arbor, (2002)
[7]  
Hryniuk W.M., Pater J.L., Implications of dose intensity for cancer chemotherapy, Semin Oncol, 14, pp. 43-44, (1987)
[8]  
Doolittle N.D., Anderson C.P., Bleyer W.A., Et al., Importance of dose intensity in neuro-oncology clinical trials: summary of the Sixth Annual Meeting of the Blood-Brain Barrier Disruption Consortium, Neuro-Oncology, 3, pp. 46-54, (2001)
[9]  
Schabel F.M., Griswold D.P., Corbett T.H., Laster W.R., Increasing the therapeutic response rates to anticancer drugs by applying the basic principles of pharmacology, Cancer, 54, pp. 1160-1167, (1984)
[10]  
Seeger R.C., Reynolds C.P., Treatment of high-risk solid tumors of childhood with intensive therapy and autologous bone marrow transplant, Pediatr Clin North Am, 38, pp. 393-424, (1991)
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