阿霉素对脑恶性胶质瘤间质化疗研究进展
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摘要
脑胶质瘤是中枢神经系统发病率最高的肿瘤,且呈恶性浸润性生长,具有高病死率及高复发率,是神经外科最难治的肿瘤之一。目前对脑恶性胶质瘤的治疗以手术切除,术后放化疗为主。由于肿瘤的生长特征,手术全切难度大;静脉化疗由于受到血脑屏障及药物全身毒性的限制,使得常规的治疗方案效果不佳。广谱抗肿瘤药物阿霉素对脑恶性胶质瘤细胞有较强的杀伤效果,间质化疗能绕过血脑屏障阻碍,同时无全身化疗的不良反应,有望成为控制脑胶质瘤术后局部复发的有效治疗手段。笔者就阿霉素对脑恶性胶质瘤间质化疗的理论基础、化疗方法、相关实验研究进展进行综述。
Glioma has the highest incidence of tumors in central nervous system, which in malignant invasive growth, and with a high mortality and high rate of recurrence, become one of the most intractable tumor of neurosurgery. Currently, the treatment of malignant glioma is surgical resection, postoperative radiation and chemotherapy. However, due to the characteristics of tumors growth, total removal is difficult,intravenous chemotherapy is limited to the blood-brain barrier(BBB) and systemic toxicity, so which lead the regular treatment to poor effect. Broad-spectrum antitumor drug doxorubicin, have intensive effect to the glioma cells. Interstitial chemotherapy can bypass the BBB effectively, which can reduce the side effect of the systemic body from chemotherapy at the same time, and will become the effective treatment of local recurrence of the glioma probably. Auther reviews the theoretical foundation, chemotherapy method, and the progress of the related experiment on Adriamycin to the interstitial chemotherapy of malignant glioma.
Glioma has the highest incidence of tumors in central nervous system, which in malignant invasive growth, and with a high mortality and high rate of recurrence, become one of the most intractable tumor of neurosurgery. Currently, the treatment of malignant glioma is surgical resection, postoperative radiation and chemotherapy. However, due to the characteristics of tumors growth, total removal is difficult,intravenous chemotherapy is limited to the blood-brain barrier(BBB) and systemic toxicity, so which lead the regular treatment to poor effect. Broad-spectrum antitumor drug doxorubicin, have intensive effect to the glioma cells. Interstitial chemotherapy can bypass the BBB effectively, which can reduce the side effect of the systemic body from chemotherapy at the same time, and will become the effective treatment of local recurrence of the glioma probably. Auther reviews the theoretical foundation, chemotherapy method, and the progress of the related experiment on Adriamycin to the interstitial chemotherapy of malignant glioma.
引文
[1]崔向丽,林松.胶质母细胞瘤国际诊疗指南比较评价[J].中国神经肿瘤杂志,2013,11(2):118-123.
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[14]张绍林,王占祥,陈玉英.经Ommaya囊局部治疗脑胶质瘤的研究进展[J].临床神经外科杂志,2011(3):164-166.
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[17]徐兵,吴林岚,黄素钦,等.穿刺植入细管注射阿霉素脂质体治疗大鼠脑胶质瘤的初步研究[J].中国癌症防治杂志,2015(2):90-94.
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[19]陈旭,刘藏,王昭,等.经Ommaya囊注射甲氨蝶呤治疗原发颅内弥漫大B细胞淋巴瘤临床研究[J].临床和实验医学杂志,2014(14):1179-1182.
[20]王勇,陶荣杰.Ommaya囊置入联合放化疗治疗肺腺癌囊性脑转移瘤的临床观察[A].中国抗癌协会、中华医学会肿瘤学分会.第八届中国肿瘤学术大会暨第十三届海峡两岸肿瘤学术会议论文汇编[C].中国抗癌协会、中华医学会肿瘤学分会,2014:2.
[21]王文波,夏学巍,杜贻庆,等.不同剂量阿霉素对脑胶质瘤术后局部化疗的临床观察[J].中国医院药学杂志,2011,31(17):1447-1450.
[22]罗唯师,罗国轩,张阳,等.体外药敏试验指导恶性脑胶质瘤化疗的临床效果及意义[J].吉林医学,2016,37(1)163-164.
[23]Mangraviti A,Tyler B,Brem H.Interstitial chemotherapy for malignant glioma:Future prospects in the era of multimodal therapy[J].Surg Neurol Int,2015,6(Suppl 1):78-84.
[2]Hochberg F H,Pruitt A.Assumptions in the radiotherapy of glioblastoma[J].Neurology,1980,30(9):907-911.
[3]Voulgaris S,Partheni M,Karamouzis M,et al.Intratumoral doxorubicin in patients with malignant brain gliomas[J].Am J Clin Oncol,2002,25(1):60-64.
[4]Kesari S,Schiff D,Drappatz J,et al.PhaseⅡstudy of protracted daily temozolomide for low-grade gliomas in adults[J].Clin Cance Res,2009,15:330-337.
[5]Perry J R,Rizek P,Cashman R.Temozolomide rechallenge in recurrent malignant glioma by using a continuous temozolomide schedule:the"rescue"approach[J].Cancer,2008,113(8):2152-2157.
[6]王硕,韩小弟.成人低分级胶质瘤治疗的NCCN指南解析[J/CD].中华临床医师杂志:电子版,2013,7(14):6213-6216.
[7]邓航,莫万彬,罗毅.阿霉素术中控缓释化疗及术后局部化疗在脑胶质瘤中的应用[J].重庆医学,2011,40(13):1302-1303.
[8]Bodell W J,Bodell A P,Giannini D D.Levels and distribution of BCNU in GBM tumors following intratumoral injection of DTI-015(BCNU-ethanol)[J].Neuro Oncol,2007,9(1):12-19.
[9]Boiardi A,Silvani A,Eoli M,et al.Treatment of recurrent glioblastoma:can local delivery of mitoxantrone improve survival[J].J Neurooncol,2008,88(1):105-113.
[10]Koch D,Hundsberger T,Boor S,et al.Local intracerebral administration of O(6)-benzylguanine combined with systemic chemotherapy with temozolomide of a patient suffering from a recurrent glioblastoma[J].J Neurooncol,2007,82(1):85-89.
[11]苏祖绿,苏海,张毅,等.脑胶质瘤化疗药物的体外敏感性实验研究[J].第三军医大学学报,2013,35(13):1420-1423.
[12]Oshiro S,Tsugu H,Komatsu F,et al.Evaluation of intratumoral administration of tumor necrosis factor-alpha in patients with malignant glioma[J].Anticancer Res,2006,26(6A):4027-4032.
[13]Patchell R A,Regine W F,Ashton P,et al.A phase I trial of continuously infused intratumoral bleomycin for the treatment of recurrent glioblastoma multiforme[J].J Neurooncol,2002,60(1):37-42.
[14]张绍林,王占祥,陈玉英.经Ommaya囊局部治疗脑胶质瘤的研究进展[J].临床神经外科杂志,2011(3):164-166.
[15]Witters L M,Santala S M,Engle L,et al.Decreased response to paclitaxel versus docetaxel in HER-2/neu transfected human breast cancer cells[J].Am J Clin Oncol,2003,26(1):50-54.
[16]Cruz M T,Duarte C B,Goncalo M,et al.The sensitizer2,4-dinitrofluorobenzene activates caspase-3 and induces cell death in a skin dendritic cell line[J].Int J Toxicol,2003,22(1):43-48.
[17]徐兵,吴林岚,黄素钦,等.穿刺植入细管注射阿霉素脂质体治疗大鼠脑胶质瘤的初步研究[J].中国癌症防治杂志,2015(2):90-94.
[18]方立仁,莫万彬.盐酸多柔比星控缓释局部化疗在脑胶质瘤的临床疗效观察与比较[J].求医问药:下半月刊,2013(1):243.
[19]陈旭,刘藏,王昭,等.经Ommaya囊注射甲氨蝶呤治疗原发颅内弥漫大B细胞淋巴瘤临床研究[J].临床和实验医学杂志,2014(14):1179-1182.
[20]王勇,陶荣杰.Ommaya囊置入联合放化疗治疗肺腺癌囊性脑转移瘤的临床观察[A].中国抗癌协会、中华医学会肿瘤学分会.第八届中国肿瘤学术大会暨第十三届海峡两岸肿瘤学术会议论文汇编[C].中国抗癌协会、中华医学会肿瘤学分会,2014:2.
[21]王文波,夏学巍,杜贻庆,等.不同剂量阿霉素对脑胶质瘤术后局部化疗的临床观察[J].中国医院药学杂志,2011,31(17):1447-1450.
[22]罗唯师,罗国轩,张阳,等.体外药敏试验指导恶性脑胶质瘤化疗的临床效果及意义[J].吉林医学,2016,37(1)163-164.
[23]Mangraviti A,Tyler B,Brem H.Interstitial chemotherapy for malignant glioma:Future prospects in the era of multimodal therapy[J].Surg Neurol Int,2015,6(Suppl 1):78-84.