Laigle-Donadey Florence, Sanson Marc
Service de neurologie Mazarin, groupe hospitalier La Pitié-Salpotrière, 75651 Paris Cedex 13.
Rev Prat. 2006 Oct 31;56(16):1779-86.
High grade gliomas are the most frequent and malignant primary brain tumours in adults. Prognosis depends on age, performance status and histological grade. Associated with symptomatic treatments, surgery, radiotherapy and chemotherapy represent the main weapons of the specific multidisciplinary therapy of malignant gliomas. Surgery is necessary for histological diagnosis. In malignant gliomas, surgery may improve survival in case of complete removal, and debulking provides an improvement of the quality of life and a symptomatic relief. Radiation therapy has been shown to improve survival in malignant glioma. The place of chemotherapy is growing not only for anaplastic oligodendrogliomas, more chemosensitive (particularly when they harbor 1p19q codeletions), but also for glioblastomas patients, which have been shown to benefit from radiotherapy plus concomitant and adjuvant temozolomide. This effect was particularly clear for patients with MGMT inactivation in the tumour, confirming here also the impact of molecular biology for future management of gliomas.
高级别胶质瘤是成人中最常见且恶性程度最高的原发性脑肿瘤。预后取决于年龄、身体状况和组织学分级。与对症治疗相关，手术、放疗和化疗是恶性胶质瘤多学科特异性治疗的主要手段。手术对于组织学诊断是必要的。在恶性胶质瘤中，若能完全切除，手术可能会提高生存率，而减瘤手术则可改善生活质量并缓解症状。放疗已被证明可提高恶性胶质瘤患者的生存率。化疗的地位日益重要，不仅对于间变性少突胶质细胞瘤（其对化疗更敏感，尤其是存在1p19q共缺失时），而且对于胶质母细胞瘤患者也如此，已证明胶质母细胞瘤患者可从放疗加同步及辅助替莫唑胺治疗中获益。对于肿瘤中MGMT失活的患者，这种效果尤为明显，这也证实了分子生物学对未来胶质瘤治疗的影响。
