Exciting new advances in neuro-oncology: the avenue to a cure for malignant glioma.
Exciting new advances in neuro-oncology: the avenue to a cure for malignant glioma.
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DOI：
10.3322/caac.20069
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发表时间：
2010-05
期刊：
影响因子：
--
通讯作者：
Olson JJ
中科院分区：
文献类型：
--
作者：
Van Meir EG;Hadjipanayis CG;Norden AD;Shu HK;Wen PY;Olson JJ
恶性胶质瘤是最常见和致命的脑肿瘤。 尽管如此，最具侵袭性的胶质母细胞瘤患者的生存率 神经胶质瘤，虽然个别变量，已改善，从平均10 在过去的5年中，由于以下方面的改善， 护理标准。放射治疗是治疗的关键 几十年来，这些病变，并有能力集中光束，并调整它， 脑肿瘤的不规则轮廓，并尽量减少剂量到附近的关键 具有强度调制或图像引导技术的结构已经得到改进 大大替莫唑胺，一种简单口服给药的烷化剂， 有利的毒性特征，与放疗联合使用或在放疗后使用。 较新的手术技术，如荧光引导切除术， 神经内镜方法，已成为重要的管理恶性肿瘤 神经胶质瘤此外，在基础和转化方面也有新的发现。 这些研究可能会在未来10年内进一步改善这种情况。 年这些药物包括阻断1种或多种紊乱肿瘤的药物， 增殖信号通路，并克服抵抗已经 现有的治疗。靶向治疗，如抗血管生成治疗， 抗血管内皮生长因子抗体（贝伐单抗） 进入临床实践。大规模的研究工作正在进行中， 提供了一个全面的了解所有的遗传变异和基因 表达改变是胶质瘤形成的基础。这些已经完善了 胶质母细胞瘤分为4种不同的分子实体， 不同的治疗方案。癌症干细胞样细胞的作用是另一个 积极调查的领域。到2020年，新的鸡尾酒 的药物将可用于靶向参与的关键分子途径， 神经胶质瘤和降低其死亡率和发病率，一个积极的发展， 病人、他们的家人和医疗专业人员都一样。
Malignant gliomas are the most common and deadly brain tumors. Nevertheless, survival for patients with glioblastoma, the most aggressive glioma, although individually variable, has improved from an average of 10 months to 14 months after diagnosis in the last 5 years due to improvements in the standard of care. Radiotherapy has been of key importance to the treatment of these lesions for decades, and the ability to focus the beam and tailor it to the irregular contours of brain tumors and minimize the dose to nearby critical structures with intensity-modulated or image-guided techniques has improved greatly. Temozolomide, an alkylating agent with simple oral administration and a favorable toxicity profile, is used in conjunction with and after radiotherapy. Newer surgical techniques, such as fluorescence-guided resection and neuroendoscopic approaches, have become important in the management of malignant gliomas. Furthermore, new discoveries are being made in basic and translational research, which are likely to improve this situation further in the next 10 years. These include agents that block 1 or more of the disordered tumor proliferation signaling pathways, and that overcome resistance to already existing treatments. Targeted therapies such as antiangiogenic therapy with antivascular endothelial growth factor antibodies (bevacizumab) are finding their way into clinical practice. Large-scale research efforts are ongoing to provide a comprehensive understanding of all the genetic alterations and gene expression changes underlying glioma formation. These have already refined the classification of glioblastoma into 4 distinct molecular entities that may lead to different treatment regimens. The role of cancer stem-like cells is another area of active investigation. There is definite hope that by 2020, new cocktails of drugs will be available to target the key molecular pathways involved in gliomas and reduce their mortality and morbidity, a positive development for patients, their families, and medical professionals alike.
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影响因子：
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