Temozolomide usage guide and instructions analysis

Indications:

1.Newly diagnosed glioblastoma is treated with concomitant radiation therapy and then as maintenance therapy.

2.Anaplastic astrocytoma: Adjuvant therapy for newly diagnosed adult anaplastic astrocytoma and treatment of adult refractory anaplastic astrocytoma.

Mechanism of action:

Temozolomide can be converted into active ingredients under physiological conditions in the bodypH, thereby inhibiting the growth of tumor cells and exerting cytotoxic functions. It mainly blocks the growth cycle of tumor cells by interfering with their synthesis of DNA, thereby inhibiting the proliferation of tumor cells. Temozolomide can regulate the body's immune response mechanism and enhance the body's ability to recognize and kill cancer cells. For patients with brain tumors, temozolomide can also reduce intracranial pressure, improve symptoms of cerebral edema, and prevent further deterioration of the condition.

Medication method:

1.For adults with newly diagnosed glioblastoma multiforme,

(1) Simultaneous radiotherapy and chemotherapy period, daily 75mg/m²total 42 days.

(2) Maintenance treatment period, 4 weeks after the end of the concurrent chemoradiotherapy period, 6 cycles of monotherapy with this product. The dose of the first cycle is 150mg/m²/ days, a total of 5 days, and then discontinued for 23 days. At the beginning of the second cycle, if the requirements are met, the dose can be increased to 200mg/m 2/ days.

2.For adult patients with recurrent or progressive glioblastoma multiforme or anaplastic astrocytoma after conventional treatment, if they have not received chemotherapy before, 200mg/m²/ days. For patients who have received chemotherapy, the starting dose of this product is 150mg/m2/days

Side effects:

1.Digestive system reactions: Temozolomide may cause symptoms such as loss of appetite, constipation, nausea and vomiting. These gastrointestinal disturbances are usually mild to moderate and resolve within 1-2 weeks.

2.Immune system effects: Drugs may cause a decrease in immunity, thereby increasing the risk of oral candidiasis infection.

3. Blood system problems: including abnormal blood count, anemia, neutropenia and thrombocytopenia, etc.

4.Nervous and psychiatric symptoms: Patients may experience anxiety, depression, emotional instability, insomnia, visual impairment, hearing damage, and abnormal taste, etc.

5.Respiratory system reactions: such as coughing and difficulty breathing.

6.Skin problems: including dry skin, allergic reactions, hair loss and rashes. Hair loss in particular, while not usually a health threat, can affect appearance.

7.Other side effects: such as muscle weakness, urinary incontinence, etc. In addition, temozolomide may cause peripheral neuropathy, such as numbness and tingling in the hands and feet, as well as fatigue and catarrh.

Warnings and precautions:

1.Risk of Pneumocystis carinii pneumonia: Patients receiving combined treatment with temozolomide and radiotherapy have an increased risk of Pneumocystis carinii pneumonia and require close observation and prevention.

2,Hepatotoxicity: Temozolomide may cause liver damage, including liver failure. Baseline liver function tests are required before treatment, and liver function monitoring is performed during and after the treatment cycle.

,3.Myelosuppression: Temozolomide may cause bone marrow suppression, manifested as pancytopenia, which may lead to aplastic anemia. Routine blood tests need to be checked regularly.

4.Genotoxicity: Temozolomide is genetically toxic. Male patients should use contraception during treatment and within 6 months after treatment.

Drug interactions:

Taking valproic acid may decrease the clearance of temozolomide by5%. Interactions with dexamethasone, prochlorperazine, phenytoin, carbamazepine, ondansetron and other drugs are not clear

Medication for special populations:

Pregnant or lactating women, and the elderly should use this medication with caution.