Emerging Therapeutic Strategies for Brain Tumors.
Emerging Therapeutic Strategies for Brain Tumors.
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脑肿瘤的新兴治疗策略。
DOI：
10.1007/s12017-021-08681-z
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发表时间：
2022
影响因子：
3.5
通讯作者：
Porter,Tyrone
中科院分区：
文献类型：
--
作者：
Aryal,Muna;Porter,Tyrone
在美国，每年诊断出近3万例原发性脑癌和30万例转移性脑癌。它具有高死亡率，并且通常对标准护理（包括手术切除，放射和化疗）无反应。这些治疗策略也受到其对健康细胞和组织的侵袭性和毒性作用的阻碍。此外，血脑/肿瘤屏障严重限制了静脉内施用的抗癌治疗剂向脑肿瘤的递送，导致肿瘤对治疗的反应差。迫切需要开发能够克服这些限制的脑癌治疗新方法。聚焦超声已经成为一种解决许多这些限制的方式，并有可能改变脑癌的治疗模式。通过颅骨传输的超声波可以聚焦在肿瘤上，并用于靶向消融或打开血管屏障以进行药物输送。本文综述了这些独特的超声技术的现状，使用这种技术治疗脑癌的不同策略，临床前模型的经验，以及临床翻译的潜力。我们还讨论了这些技术的安全性，并讨论了未来在无创规划，监测和评估超声神经干预工作的潜在途径。
Nearly thirty thousand incidences of primary and 300 thousand incidences of metastatic brain cancer are diagnosed in the USA each year. It has a high mortality rate and is often unresponsive to the standard of care, which includes surgical resection, radiation, and chemotherapy. These treatment strategies are also hindered by their invasiveness and toxic effects on healthy cells and tissues. Furthermore, the blood–brain/tumor barrier severely limits delivery of anti-cancer therapeutics administered intravenously to brain tumors, resulting in poor tumor response to the treatment. There is a critical need to develop new approaches to brain cancer therapy that can overcome these limitations. Focused ultrasound has emerged as a modality that addresses many of these limitations and has the potential to alter the treatment paradigm for brain cancer. Ultrasound transmitted through the skull can be focused on tumors and used for targeted ablation or opening the vascular barriers for drug delivery. This review provides insight on the current status of these unique ultrasound techniques, different strategies of using this technique for brain cancer, experience in preclinical models, and potential for clinical translation. We also debate the safety perspective of these techniques and discuss potential avenues for future work in noninvasive planning, monitoring, and evaluation of the ultrasonic neurointervention.