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
[11]  
Ioannidis J.P., Schmid C.H., Lau J., Meta-analysis in hematology and oncology, Hematol Oncol Clin North Am, 14, pp. 973-991, (2000)
[12]  
Stadtmauer E.A., O'Neill A., Goldstein L., Et al., Conventionaldose chemotherapy compared with high dose chemotherapy plus autologous hematopoietic stem-cell transplantation for metastatic breast cancer, N Engl J Med, 342, pp. 1069-1076, (2000)
[13]  
Cheung N.K., Heller G., Chemotherapy dose intensity correlates strongly with response, median survival, and median progression-free survival in metastatic neuroblastoma, J Clin Oncol, 9, pp. 1050-1058, (1991)
[14]  
Finlay J.L., August C., Packer R., Et al., High-dose multi-agent chemotherapy followed by bone marrow ‘rescue’ for malignant astrocytomas of childhood and adolescence, J Neuro-Oncol, 9, pp. 239-248, (1990)
[15]  
Kalifa C., Hartmann O., Demeocq F., Et al., High-dose busulfan and thiotepa with autologous bone marrow transplantation in childhood malignant brain tumors: a phase II study, Bone Marrow Transplant, 9, pp. 227-233, (1992)
[16]  
Mahoney D.H., Strother D., Camitta B., Et al., High-dose melphalan and cyclophosphamide with autologous bone marrow rescue for recurrent/progressive malignant brain tumors in children: a pilot Pediatric Oncology Group study, J Clin Oncol, 14, pp. 382-388, (1996)
[17]  
Tada T., Takizawa T., Nakazato F., Et al., Treatment of intracranial nongerminous germ-cell tumors by high dose chemotherapy and autologous stem-cell rescue, J Neuro-Oncol, 44, pp. 71-76, (1999)
[18]  
Graham M.L., Herndon J.E.I.I., Casey J.R., Et al., High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors, J Clin Oncol, 15, pp. 1814-1823, (1997)
[19]  
Mason W.P., Grovas A., Halpern S., Et al., Intensive chemotherapy and bone marrow rescue for young children with newly diagnosed malignant brain tumors, J Clin Oncol, 16, pp. 210-221, (1998)
[20]  
Cairncross G., Swinnen L., Bayer R., Et al., Myeloablative chemotherapy for recurrent aggressive oligodendroglioma, Neuro-Oncology, 2, pp. 114-119, (2000)
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