Chang Susan M, Butowski Nicholas A, Sneed Patricia K, Garner Ilona V
Department of Neurological Surgery, University of California, San Francisco, California 94143-0350, USA.
Neurosurg Focus. 2006 Apr 15;20(4):E4.
Glioblastoma multiforme (GBM) tumors almost invariably recur despite initial treatments. Correct diagnosis using a variety of imaging techniques and the involvement of a multidisciplinary tumor board are critical for evaluating each stage of a patient's progression and determining optimal management. Standard therapies for recurrence generally include repeated resection, radiation therapy, chemotherapy, and supportive care; however, salvage therapy must be highly individualized, and not all patients are eligible for every type of standard therapy. Factors such as the size and location of the tumor, previous treatment, and general health of the patient must be taken into consideration. Although standard therapies can prolong a patient's duration of survival, the median survival time for patients with recurrent GBM is usually less than 1 year. Experimental targeted drug therapies have been developed to inhibit aberrant cell-signaling pathways involved in tumorigenesis, and enrolling patients in clinical trials using these therapies is another option for treatment of recurrent GBM. The use of these novel therapies is often confined to large research institutions, but the severe limitations of standard treatment options make it important to highlight the potential of experimental therapies. In this paper the authors outline standard therapies and review the emerging role of targeted drug therapy in the treatment of recurrent GBM.
多形性胶质母细胞瘤（GBM）肿瘤尽管进行了初始治疗，但几乎总是会复发。使用多种成像技术进行正确诊断以及多学科肿瘤委员会的参与对于评估患者病程的每个阶段并确定最佳治疗方案至关重要。复发的标准治疗通常包括重复切除、放射治疗、化疗和支持治疗；然而，挽救治疗必须高度个体化，并非所有患者都适合每种标准治疗类型。必须考虑肿瘤的大小和位置、先前的治疗以及患者的一般健康状况等因素。尽管标准治疗可以延长患者的生存时间，但复发性GBM患者的中位生存时间通常不到1年。已经开发出实验性靶向药物疗法来抑制参与肿瘤发生的异常细胞信号通路，让患者参加使用这些疗法的临床试验是复发性GBM治疗的另一种选择。这些新型疗法的使用通常局限于大型研究机构，但标准治疗方案的严重局限性使得突出实验性疗法的潜力很重要。在本文中，作者概述了标准疗法并回顾了靶向药物疗法在复发性GBM治疗中的新兴作用。
