Robins H Ian, Peterson Christopher G, Mehta Minesh P
Department of Medicine, University of Wisconsin, Madison, WI 53792, USA.
Semin Oncol. 2003 Aug;30(4 Suppl 9):11-22. doi: 10.1016/s0093-7754(03)00271-9.
This review summarizes the current status and future prospects for combined modality treatment of primary and metastatic central nervous system malignancies. The laboratory and clinical basis for multimodality therapy, including surgery, ionizing radiation, and drug therapy, are outlined and critically reviewed. The central nervous system diseases discussed include: glioma (low and high grade), brain metastases, and primary central nervous system lymphoma. Collectively, these data suggest a shift favoring combined modality approaches in several of these diseases; however, the incremental gains are indeed modest. The individual practitioner must weigh these with the additional toxicities before making a therapeutic decision for a particular patient. The future direction of combined modality therapy in these diseases will likely revolve around the increased use of molecular diagnostics resulting in the application of targeted therapy. Clearly, such promising innovations must be delineated in the context of continued preclinical studies and controlled clinical trials.
本综述总结了原发性和转移性中枢神经系统恶性肿瘤联合治疗的现状和未来前景。概述并严格审查了多模态治疗的实验室和临床基础，包括手术、电离辐射和药物治疗。所讨论的中枢神经系统疾病包括：胶质瘤（低级别和高级别）、脑转移瘤和原发性中枢神经系统淋巴瘤。总体而言，这些数据表明在其中几种疾病中联合治疗方法更受青睐；然而，实际增加的疗效确实有限。个体从业者在为特定患者做出治疗决策之前，必须权衡这些因素以及额外的毒性。这些疾病联合治疗的未来方向可能围绕增加分子诊断的应用，从而实现靶向治疗。显然，这种有前景的创新必须在持续的临床前研究和对照临床试验的背景下加以阐述。
