這是我提出的問題
M.D., Martin J. van den Bent M.D., et. Al
(English Translation Version)
Brief Medical History Of Chang Ya Chi
(female, aged 43) and Her Concerns
Temozolomide, was reported effective in
treating malignant brain tumor if used
together with radiotherapy. Owing to the
location of the brain tumor, it is unlikely for
the patient to have a biopsy, thus unable to
tell the nature of the tumor, either
malignant or benign. Within a year, the
patient has undergone three (3) MRI plus
MRS exams. According to the recent MRI
Report, the brain tumor remains about the
same size as before without an imminent
growth. However, the patient is
complaining of numbness and weakness
of left hand and foot and the condition is
getting worse. Based on the symptoms
and the reports, about three or four foreign
neurologists therefore made their
diagnoses as low grade Glioblastoma. An
overseas neurosurgeon recommended
that the patient just take Temozolomide
for six (6) months with no need to undergo
radiotherapy, if it is ineffective or does not
work well after six months, then stop
taking it. What do you think?
Finally, is Temozolomide supposed to be
taken by mouth or to be for chemotherapy
use or can be for both purposes? Is
Temozolomide also effective in treating
benign brain tumor? Is it necessary to be
used simultaneously with radiotherapy?
Your time and comments in this regard
would be greatly appreciated.
Hey Mike, whats your experience on using Temozolomide w/ or w/out radiosurgery for a supposedly low grade glioma (from what I remember,this patient had an over 2cm glioma that was close to the brainstem)? 這是美國醫生針對我的問題做回應的 From: Jason L 這是另一個醫生的意見 From: Michael L Date: Mon, May 11, 2009 at 10:54 AM Subject: Re: Temozolomide for Glioblastoma To: Jason L Hi Jason, Temozolamide is usually not used for Low grades. If anything, radiation is usually used first. If it's a GBM or Grade III, then temozolamide with radiation is the right choice. 對這個藥物本人沒有任何意見 我只針對自己遇到的事情找一個適合我的答 案 每個人症狀不同 治療也不同 我也是同時想傳達是 用藥之前 應該多問醫生概念 藥物一定有它的副作用 但是不一定在每一個人身上會出現 感謝大家來我的部落格
Date: Mon, May 11, 2009 at 8:24 AM
To: Howard Hwang
Hi Mr. and Mrs. Hwang,
At this point, it does not seem that Temozolamide in conjunction with
radiation therapy is needed for Mrs. Chang Ya-chi, especially given
that her tumor is low grade. The advantage of Temozolamide over other
chemotherapy choices is 1) It is effective in slowing growth of high
grade gliomas and 2) it has a low side effect profile and therefore
affords her a decent quality of life. However, since her tumor is
very slow growing already, Temozolamide would really add little
benefit and if anything will just make her feel worse. There is
always a worse case scenario as well in that Temozolamide may change
the cellular nature of her tumor and it may respond by growing more
aggressively (although this is less likely). With her grade tumor,
radiation therapy alone is the best option to help shrink the tumor.
If they see that her tumor begins to rapidly grow and they upgrade its
grading to a Grade III glioma or GBM, then I think temozolamide may be
considered (See Dr. Lim's comment below). I hope all is well and
please e-mail me or call me if you have any further questions.
Best wishes,
Hope this helps otherwise just give me a call!
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