Immunotherapy of patients with glioma: fact, fancy, and future.
Immunotherapy of patients with glioma: fact, fancy, and future.
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神经胶质瘤患者的免疫治疗：事实、幻想和未来。
DOI：
10.1159/000408241
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Gillespie,GY
中科院分区：
文献类型：
--
作者：
MahaleyJr,MS;Gillespie,GY
考虑到对天然食物、自然分娩、天然洗发水等的强调的复兴，潜在地使用“天然”防御来对抗癌症是一个有吸引力的概念。动员这种防御的可能性促进了积极调查的几个领域。在这些方法中可以包括免疫疗法。对于间变性胶质瘤患者，目前最有效的治疗方法是根治性手术切除肿瘤，然后同时进行放疗和全身化疗[58]。除了治疗在严格受限的空间中生长的相对难以接近的肿瘤所涉及的明显困难之外，在目前实践的脑肿瘤治疗中存在几个固有的时间性质的战略问题。实际治疗时间与疾病持续时间的比率相当低。手术切除不能在整个病程中重复进行;此外，它可能是最有限的时间限制的治疗形式。放射治疗，因为它是现在最常用的做法，暴露在大脑内的所有细胞的辐射，每天短暂的间隔，在6-7周的时间。即使采用创新的超分割方案，累积剂量也会增加正常脑细胞的耐受性，使它们可能容易受到辐射的有害影响。目前，化疗本身并不是一种可以不间断应用的方式，目前关于化疗暴露的途径和时间的概念大多是经验性的，主要由患者的耐受性以及医生的便利性决定。其他新的方式，如热疗，放射增敏剂，间质照射，低剂量的“连续”放射治疗仍然代表不连续的治疗形式，如果不是，实际上，只有一次性治疗[4，7，48]。
Considering the resurgence of emphasis on natural foods, natural childbirth, natural shampoos, and the like, the potential use of'natural'defenses to fight cancer is an attractive concept. The possibility of mobilizing such defenses has fostered several areas of active investigation. Among these approaches could be included immunotherapy. The most efficacious treatment available now for patients with anaplastic gliomas consists of radical surgical resection of the tumor followed by concurrent irradiation and systemic chemotherapy [58]. Other than the obvious difficulties involved in treating a relatively inaccessible neoplasm growing in a rigidly confined space, there are several strategic problems of a temporal nature inherent in brain tumor therapy as it is currently practiced. The ratio of actual treatment time to duration of the disease is quite low. Surgical resection cannot be performed repeatedly throughout the course of the disease; furthermore, it is probably the form of treatment with the most finite temporal limitations. Radiation therapy, as it is now most commonly practiced, exposes all of the cells within the brain to radiation for a brief interval each day over a period of 6-7 weeks. Even with innovative hyperfractionation schemes, the cumulative dose stresses the tolerance of normal brain cells, making them potentially vulnerable to the harmful effects of radiation. Chemotherapy itself is not a modality that can be applied without interruption at the present time, and the current concepts regarding both the route and timing of chemotherapeutic exposure are mostly empirical, being determined mainly by the patient's tolerance as well as by the convenience to the physician. Other novel modalities, such as hyperthermia, radiosensitizers, interstitial irradiation, and low-dose'continuous' radiation therapy still represent discontinuous forms of therapy, if not, indeed, one-time treatments only [4, 7, 48].