Chemotherapy in patients with brain metastases
Chemotherapy in patients with brain metastases
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DOI：
10.1007/s12254-008-0025-2
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发表时间：
2008-06-01
影响因子：
0.6
通讯作者：
Marosi, C.
中科院分区：
文献类型：
--
作者：
Marosi, C.
脑转移的发展仍然被认为是癌症疾病的“晚期并发症”。中枢神经系统转移的可能性在神经外胚层来源的肿瘤如黑色素瘤或小细胞肺癌中最大，在外胚层来源的肿瘤如乳腺癌和非小细胞肺癌中非常高，而其他胚胎来源的肿瘤发生脑转移的可能性较小。VEGF表达上调的肿瘤细胞新血管化促进了它们通过血脑屏障的转运。替莫唑胺和“小分子”目前正在实体肿瘤中作为法尼基转移酶抑制剂和酪氨酸激酶抑制剂进行研究，这些抑制剂能够穿过血脑屏障，因此在大脑中应该是活跃的。虽然对脑转移瘤化疗的研究通常很小，而且主要包括少数患者，但已有反应和生存期延长的记录。新的治疗药物在提高治疗率和减少化疗副作用方面的潜力需要更多的研究来评估。
The development of brain metastases is still considered as a "terminal complication'' of a cancer disease. The potential for CNS metastases appears to be greatest in tumours of neuroectodermal origin like melanoma or SCLC, very high in patients with tumours of ectodermal origin like breast cancer and NSCLC, whereas tumours arising from other embryonic origin develop brain metastases less often. Neovacularisation with upregulated VEGF Expression by the tumour cells facilitates their transmigration through the BBB. Temozolomide and "small molecules'' are currently under investigation in solid tumours as farnesyltransferase inhibitors and tyrosin kinase inhibitors are able to cross BBB and thus should be active within the brain. Although studies on chemotherapy of brain metastases are usually small and include mostly a small number of patients, responses and prolongations of survival have been recorded. More studies are needed to evaluate the potential of the new therapeutics agents which increased therapeutic ratio and reduced side effects from chemotherapy.