Desjardins Annick, Rich Jeremy N, Quinn Jennifer A, Vredenburgh James, Gururangan Sridharan, Sathornsumetee Sith, Reardon David A, Friedman Allan H, Bigner Darell D, Friedman Henry S
The Brain Tumor Center, Department of Pediatrics, Duke University Medical Center, 047 Baker House, Trent Drive, Box 3624, Durham, NC 27710, USA.
Front Biosci. 2005 Sep 1;10:2645-68. doi: 10.2741/1727.
Glial neoplasms represent 0.5-1% of all cancers in most Western countries. Malignant gliomas are among the most devastating cancers, leading to death in most cases. They present unique challenges due to their location, aggressive biological behavior and diffuse infiltrative growth. Notwithstanding the development of new surgical and radiation techniques in the last thirty years, a cure for malignant gliomas remains elusive. In this article, we will review the standard and new therapies used for malignant gliomas. As standard therapies, surgery, radiation therapy and systemic chemotherapy, are in a continuous process of evolution. Multiple chemotherapies have been used in malignant gliomas, as single agents, in combination, or with different modes of administration, including high-dose chemotherapy with stem cell rescue and intra-arterial chemotherapy. The last decade has been noticeable for the advent of a better understanding of the biology of malignant gliomas. This has stimulated active research in multiples areas and the advent of new treatment strategies. Techniques to circumvent the resistance mechanisms to chemotherapy have been evaluated, tyrosine kinase inhibitors have shown activity in malignant primary brain tumors and radioimmunotherapy remains an area of active research. In this article, we review the past, present and future treatments of malignant gliomas with a special interest on chemotherapy, resistance mechanisms and tyrosine kinase inhibitors.
在大多数西方国家，神经胶质瘤占所有癌症的0.5%-1%。恶性胶质瘤是最具毁灭性的癌症之一，大多数情况下会导致死亡。由于其位置、侵袭性生物学行为和弥漫性浸润性生长，它们带来了独特的挑战。尽管在过去三十年中出现了新的手术和放疗技术，但恶性胶质瘤的治愈方法仍然难以捉摸。在本文中，我们将回顾用于恶性胶质瘤的标准疗法和新疗法。作为标准疗法，手术、放疗和全身化疗都处于不断发展的过程中。多种化疗药物已用于恶性胶质瘤，作为单一药物、联合使用或采用不同的给药方式，包括高剂量化疗联合干细胞救援和动脉内化疗。过去十年因对恶性胶质瘤生物学有了更好的理解而引人注目。这激发了多个领域的积极研究以及新治疗策略的出现。规避化疗耐药机制的技术已得到评估，酪氨酸激酶抑制剂在恶性原发性脑肿瘤中显示出活性，放射免疫疗法仍然是一个积极研究的领域。在本文中，我们回顾恶性胶质瘤的过去、现在和未来治疗方法，特别关注化疗、耐药机制和酪氨酸激酶抑制剂。
