Primary brain tumours in adults
Primary brain tumours in adults
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DOI：
10.1016/s0140-6736(11)61346-9
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发表时间：
2012-05-26
期刊：
影响因子：
168.9
通讯作者：
Delattre, Jean-Yves
中科院分区：
文献类型：
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作者：
Ricard, Damien;Idbaih, Ahmed;Delattre, Jean-Yves
重要的进展已经取得了理解和管理成人胶质瘤和原发性中枢神经系统淋巴瘤-两个最常见的原发性脑肿瘤。成像技术的进步使我们能够更好地分析这些肿瘤的性质和分级。来自大型3期研究的发现已经产生了一些胶质瘤的标准治疗，并且已经证实了特定分子改变的预后价值。能够对肿瘤进行全基因组分析的高通量方法提高了肿瘤生物学的知识，这将导致更好地对胶质瘤进行分类，并为所谓的靶向治疗试验铺平道路。原发性中枢神经系统淋巴瘤是一组罕见的非霍奇金淋巴瘤。高剂量的甲氨蝶呤治疗方案可以提高生存率，但治疗标准和全脑放疗的位置仍不清楚，可能取决于患者的年龄。现在的重点是开发新的综合化疗方案，以减少或推迟全脑放疗及其延迟并发症。
Important advances have been made in the understanding and management of adult gliomas and primary CNS lymphomas-the two most common primary brain tumours. Progress in imaging has led to a better analysis of the nature and grade of these tumours. Findings from large phase 3 studies have yielded some standard treatments for gliomas, and have confirmed the prognostic value of specific molecular alterations. High-throughput methods that enable genome-wide analysis of tumours have improved the knowledge of tumour biology, which should lead to a better classification of gliomas and pave the way for so-called targeted therapy trials. Primary CNS lymphomas are a group of rare non-Hodgkin lymphomas. High-dose methotrexate-based regimens increase survival, but the standards of care and the place of whole-brain radiotherapy remain unclear, and are likely to depend on the age of the patient. The focus now is on the development of new polychemotherapy regimens to reduce or defer whole-brain radiotherapy and its delayed complications.