Behin Anthony, Hoang-Xuan Khe, Carpentier Antoine F, Delattre Jean-Yves
Fédération de Neurologie Mazarin, G H Pitié-Salpêtrière, 75013, Paris, France.
Lancet. 2003 Jan 25;361(9354):323-31. doi: 10.1016/S0140-6736(03)12328-8.
The most frequent primary brain tumours in adults are gliomas and primary CNS lymphomas. In gliomas, molecular genetic analysis plays an increasing part in classification and treatment planning, a feature well illustrated by the chemosensitive oligodendrogliomas. Unfortunately, management of glioblastoma is still mainly palliative. Incidence of primary CNS lymphoma has increased strikingly in the past 20 years; substantial progress has been achieved in patients who are immunocompetent with the addition of methotrexate-based chemotherapy to radiotherapy, but the potential neurotoxic effects of this combination in elderly patients is worrisome.
成人中最常见的原发性脑肿瘤是胶质瘤和原发性中枢神经系统淋巴瘤。在胶质瘤中,分子遗传学分析在分类和治疗规划中发挥着越来越重要的作用,化学敏感性少突胶质细胞瘤就很好地说明了这一特点。不幸的是,胶质母细胞瘤的治疗仍然主要是姑息性的。原发性中枢神经系统淋巴瘤的发病率在过去20年中显著增加;在免疫功能正常的患者中,在放疗基础上加用基于甲氨蝶呤的化疗已取得了实质性进展,但这种联合治疗对老年患者潜在的神经毒性作用令人担忧。