有谁了解泰道（替莫唑安）这个药？对腺癌脑转移效果好吗？怎么用？费用？

lovemiracle 发表于 2008-6-30 11:15:06

有谁了解泰道（替莫唑安）这个药？对腺癌脑转移效果好吗？怎么用？费用？急！！谢谢！！！

lovemiracle 发表于 2008-7-1 01:05:25

Phase II study of temozolomide and concomitant whole-brain radiotherapy in patients with brain metastases from solid tumors.替莫唑安联合全脑放疗治疗实体瘤脑转移的二期临床研究<a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Kouvaris%20JR%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Kouvaris JR</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Miliadou%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Miliadou A</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Kouloulias%20VE%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Kouloulias VE</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Kolokouris%20D%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Kolokouris D</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Balafouta%20MJ%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Balafouta MJ</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Papacharalampous%20XN%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Papacharalampous XN</a>, <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Vlahos%20LJ%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus">Vlahos LJ</a>.Department of Radiation Oncology, <place wst="on"><city wst="on">University of Athens</city>, <country-region wst="on">Greece</country-region></place>. johnkouv@aretaieio.uoa.grBACKGROUND: The aim of this study was to evaluate the effectiveness and possible toxicity of the combination of temozolomide (TMZ) with whole-brain irradiation (WBI) in the treatment of brain metastases from solid tumors. 目的是评价替莫唑安联合全脑放疗治疗实体瘤脑转移有效性及可能的毒副作用PATIENTS AND METHODS: 33 patients with brain metastases were included in the study and treated with TMZ 60 mg/m2/day (days 1-16) concomitantly with WBI (36 Gy/12 fractions given in 16 days). One month after the end of radiotherapy, 6 cycles of TMZ were administered as adjuvant treatment (200 mg/m2/day for 5 consecutive days every 28 days).33例脑转移瘤的病人参加实验，给予替莫唑安60mg每平方米体表面积每天（1-16天）同时进行全脑放疗（36Gy/12fractions共16天）。放疗结束后一个月，给予6个周期的替莫唑安作为后续辅助治疗（200mg每平方米体表面积每天连续5天为一个疗程，每28天作一次）RESULTS: Responses were assessed using computed tomography at the end of the 3rd and 6th cycle of chemotherapy. The objective response rate was 54.5% and 57.6% after the 3rd and the 6th cycle, respectively. The median overall survival was 12 months. In patients with metastases from lung cancer the objective response rate was 11/14 (78.6%) after both the 3rd and the 6th cycle of treatment. The most common side effects were anemia (24.2%), thrombocytopenia (18.2%), as well as nausea and vomiting (18.2%). The high incidence of hepatotoxicity (45.5%) might be related to concomitantly administered antiepileptic drugs and not to TMZ.用药的第三个和第六个周期，通过CT评价。反应率在第三个和第六个周期分别为54.5% and 57.6%。中位生存期为12个月。在肺癌脑转移的病人，完成第三和第六周期后的反应率为11/14 (78.6%)。最常见的副作用为贫血(24.2%)、血小板减少(18.2%)和恶心呕吐(18.2%)。肝毒性有很高的发生率(45.5%)，可能与同时应用的抗癫痫药物有关而与替莫唑安无关。CONCLUSION: WBI combined with TMZ as concomitant and adjuvant treatment is effective in treating brain metastases, with acceptable mild side effects.全脑放疗联合替莫唑安治疗脑转移瘤有效，其副作用也可以接受。PMID: 17596744

lovemiracle 发表于 2008-7-1 01:29:08

既然没人回复，想必是大家经验都不多，自己读了些文献放在这，大家参考。

lovemiracle 发表于 2008-7-1 01:35:14

上篇文献33例病人的临床特征small cell lung cancer (n = 4), 非小细胞肺癌占10例non-small cell lung cancer (n = 10), breast cancer (n = 7), rectal cancer and malignant melanoma (n = 5 each),and oral and unkown origin (n = 1 each).

lovemiracle 发表于 2008-7-1 02:22:34

2007年6月13号发表在ONKOLOGIE的一篇有关替莫唑安(泰道)联合全脑放疗的综述。 Whether there is truly a rationale for adjuvant temozolomide in such trials, needs probably to be defined for each single type of primary tumor. Depending on the intrinsic sensitivity of each tumor entity to temozolomide,adjuvant treatment may or may not modify systemic end-points as well.The same considerations apply to similar ap-proaches using other agents such as topotecan which may exert both radiosensitizing effects as well as intrinsic antitu-mor activity.

baixiaoxin 发表于 2008-7-1 21:36:28

泰道抗脑转移瘤非常有效,但似乎副作用也很明显

我母亲在肺癌脑转移,行全脑放疗后再一月有余之后,服用了三个疗程的泰道(先灵葆雅公司出), 其中一个疗程300mg连用5天，另两个疗程240mg。半年后检查，脑部转移灶大幅度减少，但服药过程中呕吐、无食欲、便秘、尿路感染、小便失禁、白细胞减少等屡见不鲜。价格（大约，记不清了）：100mg 5粒装 5300元20mg5粒装 1280元但第三个疗程服用后（08年5月），发现脑部好消息的同时，从CT上发现肺癌在服用易瑞沙8个月后开始进展，我这一个月一直在后悔勉强吃这第三个疗程的泰道。之所以服用，第一因为医生强烈要求，二是因为母亲抱怨头痛难忍，现在怀疑不是脑瘤作祟，而是全脑放疗后脑水肿产生的痛楚。后悔不迭！！但这还是我个人的观察结论，同时temodal的抗脑转移瘤效果不容抹煞。

lovemiracle 发表于 2008-7-2 02:32:41

谢谢您给出的经验，想必是天坛医院的医生建议的吧。没想到副作用这么大。临床试验大部分应用泰道的都是和放疗同时开始。您母亲脑转移放疗后是没有控制住吗？所以才用泰道？

lovemiracle 发表于 2008-7-2 02:37:32

您母亲是什么病理类型？是什么分化程度？脑转移病灶是什么情况？盼望和您进一步交流？我的QQ750644291.我现在美国。妈妈也是肺癌脑转移，中分化腺癌。现在脑部3个病灶，最大不到一厘米。

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有谁了解泰道（替莫唑安）这个药？对腺癌脑转移效果好吗？怎么用？费用？

泰道抗脑转移瘤非常有效,但似乎副作用也很明显