Advances in Radiotherapy for Glioblastoma.

Advances in Radiotherapy for Glioblastoma.
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放射疗法的胶质母细胞瘤进展。

DOI:
10.3389/fneur.2017.00748
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发表时间:
2017
影响因子:
3.4
通讯作者:
Wernicke AG
Wernicke AG
中科院分区:
医学3区
文献类型:
--
作者:
Mann J;Ramakrishna R;Magge R;Wernicke AG

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体外放射治疗(RT)在胶质母细胞瘤的治疗中起着至关重要的作用。在过去的几十年里,放射治疗和图像引导技术的重大进步导致了优化最终和挽救治疗的能力的巨大改进。该综述重点介绍了与放射治疗相关的几个最新进展和争议,包括老年患者的治疗,他们仍然是一个脆弱和脆弱的群体;复发疾病的潜在挽救选择,包括化疗再照射;最新的成像技术,可以更准确和精确地描绘治疗量,以最大限度地提高适形放射治疗的治疗比率;正在进行的关于免疫治疗和放射治疗相结合的临床前和临床数据;以及越来越多的证据表明,脑室下区存在癌症干细胞生境,这可能为局部治疗提供潜在的靶点。最后,在许多方面的持续发展使结果略有改善,同时限制了毒性。
External beam radiotherapy (RT) has long played a crucial role in the treatment of glioblastoma. Over the past several decades, significant advances in RT treatment and image-guidance technology have led to enormous improvements in the ability to optimize definitive and salvage treatments. This review highlights several of the latest developments and controversies related to RT, including the treatment of elderly patients, who continue to be a fragile and vulnerable population; potential salvage options for recurrent disease including reirradiation with chemotherapy; the latest imaging techniques allowing for more accurate and precise delineation of treatment volumes to maximize the therapeutic ratio of conformal RT; the ongoing preclinical and clinical data regarding the combination of immunotherapy with RT; and the increasing evidence of cancer stem-cell niches in the subventricular zone which may provide a potential target for local therapies. Finally, continued development on many fronts have allowed for modestly improved outcomes while at the same time limiting toxicity.
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