PCNU and recurrent childhood brain tumors.
PCNU and recurrent childhood brain tumors.
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PCNU 和复发性儿童脑肿瘤。
DOI：
10.1007/bf00151228
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发表时间：
1987
影响因子：
3.9
通讯作者：
Tan,C
中科院分区：
文献类型：
--
作者：
Allen,JC;Hancock,C;Walker,R;Tan,C
PCNU是最新进入临床试验的亚硝基脲类似物，在实验室研究中具有更有利的生化和细胞毒性特性，有望成为脑肿瘤的上级化疗药物。39名患有各种复发性原发性CNS肿瘤的儿童参加了一项11期PCNU试验，他们都有可评估的疾病。年龄3-20岁，平均9.7岁。PCNU以2小时静脉输注给药，间隔6-7周;最低限度治疗患者为100-125 mg/m2，重度治疗患者为70-90 mg/m2。在尝试逐渐减少类固醇剂量后，在2个疗程的化疗后评估反应。总体客观缓解率为18%（7/39），平均5.9个月（2+−12）。仅观察到部分缓解。疾病特异性缓解率为：脑干胶质瘤- 18%（3/17）;脑胶质瘤- 27%（3/12）;室管膜瘤- 1/1;原始神经外胚层肿瘤-（0/9），包括5例髓母细胞瘤、2例松果体母细胞瘤和3例脑原始神经外胚层肿瘤。毒性主要是血液学的，在30/38（79%）例患者试验中遇到了临床显著的血小板减少症（< 50000 mm 3）。PCNU在复发性儿童胶质瘤中的适度活性得到证实。我们的反应率，使用客观的CT标准，略低于BCNU和CCNU报告。由于血液学毒性和疗效相当，静脉内PCNU似乎没有提供一个临床优势，现有的亚硝基脲的儿童复发性脑肿瘤使用2小时静脉输注时间表。
PCNU the latest nitrosourea analogue to be subjected to clinical trials, held promise as a superior chemotherapy agent for brain tumors because of more favorable biochemical and cytotoxic characteristics in laboratory studies. Thirty-nine children with a variety of recurrent primary CNS tumors, all of whom had evaluable disease, participated in a phase 11 PCNU trial. Their mean age was 9.7 (3–20) years. PCNU was administered as a 2 hour intravenous infusion in one of 2 dose schedules at 6–7 week intervals; 100–125 mg/m2 for minimally treated patients and 70–90 mg/m2for heavily treated patients. Response was assessed after 2 courses of chemotherapy after attempting to taper the steroid dose. The overall objective response rate was 18% (7/39) for a mean of 5.9 months (2+−12). Only partial responses were observed. Disease-specific responses rates were: brainstem glioma - 18% (3/17); cerebral glioma - 27% (3/12); ependymoma- 1/1; and primitive neuroectodermal tumors - (0/9) including 5 medulloblastomas, 2 pineoblastomas and 3 cerebral primitive neuroectodermal tumors. Toxicity was primarily hematologic and clinically significant thrombocytopenia (< 50000 mm3) was encountered in 30/38 (79%) patient trials. Modest activity of PCNU in recurrent childhood gliomas is confirmed. Our response rates, using objective CT criteria, are somewhat lower than those reported for BCNU and CCNU. Because of comparable hematologic toxicity and efficacy, intravenous PCNU does not appear to offer a clinical advantage to existing nitrosoureas for children with recurrent brain tumors using a 2 hour intravenous infusion schedule.