Malignant Glioma
Malignant Glioma
复制标题
DOI：
10.1007/978-3-031-23705-8_1
复制
发表时间：
2023-01-01
期刊：
影响因子：
--
通讯作者：
Bruce, Jeffrey N.
中科院分区：
文献类型：
--
作者：
Wang, Linda M.;Englander, Zachary K.;Bruce, Jeffrey N.
本章提供了一个全面的概述恶性胶质瘤，最常见的原发性脑肿瘤在成人。在显微镜下，这些肿瘤的细胞起源、基因谱和形态各不相同，但它们共同具有体内所有肿瘤中最令人沮丧的预后。虽然目前还没有治愈恶性胶质瘤的方法，但持续改善这些肿瘤患者预后的努力已经导致了生存率的适度提高，世界各地的研究人员继续努力，以更深入地了解影响胶质瘤发展和治疗反应的因素。除了明确的流行病学、临床表现、恶性胶质瘤的常见组织病理学和放射学特征外，本节还考虑了分子生物学的最新进展，这些进展使人们对不同类型恶性胶质瘤的遗传变化特征有了更细致的了解，以及它们对治疗的影响。除了基于组织病理学特征的恶性胶质瘤的传统分类之外，本章还结合了世界卫生组织2016年脑肿瘤分类标准，特别关注疾病定义的遗传改变和新建立的恶性胶质瘤亚类，这些亚类以前仅通过显微镜检查无法识别。本文详细回顾了恶性胶质瘤的传统治疗方式，如积极手术切除后辅助化疗和放疗，以及支持其疗效的研究。这为进一步讨论新的治疗方法（如免疫治疗和对流增强输送）以及增强切除程度的新技术（如荧光引导手术）提供了基础。
This chapter provides a comprehensive overview of malignant gliomas, the most common primary brain tumor in adults. These tumors are varied in their cellular origin, genetic profile, and morphology under the microscope, but together they share some of the most dismal prognoses of all neoplasms in the body. Although there is currently no cure for malignantglioma, persistenteffortsto improve outcomes in patients with these tumors have led to modest increases in survival, and researchers worldwide continue to strive toward a deeper understanding of the factors that influence glioma development and responsetotreatment. Inadditionto well-established epidemiology, clinical manifestations, and common histopathologic and radiologic features of malignant gliomas, this section considers recent advances in molecular biology that have led to a more nuanced understanding of the genetic changes that characterize the different types of malignant glioma, as well as their implications for treatment. Beyond the traditional classification of malignant gliomas based on histopathological features, this chapter incorporates the World Health Organization's 2016 criteria for the classification of brain tumors, with special focus on disease-defining genetic alterations and newly established subcategories of malignant glioma that were previously unidentifiable based on microscopic examination alone. Traditional therapeutic modalities that form the cornerstone of treatment for malignant glioma, such as aggressive surgical resection followed by adjuvant chemotherapy and radiation therapy, and the studies that support their efficacy are reviewed in detail. This provides a foundation for additional discussion of novel therapeutic methods such as immunotherapyandconvection-enhanced delivery, as well as new techniques for enhancing extent of resection such as fluorescence-guided surgery.