Salvati Maurizio, D'Elia Alessandro, Formichella Anna Isabella, Frati Alessandro
IRCCS INM Neuromed, Department of Neurosurgery, Pozzilli, Italy.
Expert Opin Pharmacother. 2009 Oct;10(14):2279-90. doi: 10.1517/14656560903146910.
Malignant gliomas are the most common primary brain tumors in adults. In the past 10 years significant advances in the treatment of this entity have been made, mainly owing to a better understanding of molecular pathways and biological behavior of the oncogenetic process. This review treats the proven effective and promising approaches with chemotherapy. The standard care for glioblastoma is surgery and concomitant radio- and chemotherapy with temozolomide (TMZ), followed by adjuvant treatment with TMZ. It has been demonstrated to be the most effective treatment protocol. This standardized care allows the application and study of new types of treatment mainly in recurrences and nonresponding patients. Many different approaches have been investigated: the combination of cytotoxic and cytostatic agents as well as molecular targeted therapies have given some encouraging results. Further intensified regimens with TMZ and the local postsurgical application of slow-release polymers loaded with carmustine remain to be defined. The characterization of molecular markers thus becomes particularly important for the stratification of patients raising the possibility to individualize treatment.
恶性胶质瘤是成人中最常见的原发性脑肿瘤。在过去10年里，该疾病的治疗取得了重大进展，这主要归功于对分子途径和致癌过程生物学行为的更好理解。本综述探讨了经证实有效的化疗方法以及有前景的化疗方法。胶质母细胞瘤的标准治疗方案是手术，同时进行放疗和替莫唑胺（TMZ）化疗，随后进行TMZ辅助治疗。这已被证明是最有效的治疗方案。这种标准化治疗使得新型治疗方法主要应用于复发患者和无反应患者并对其进行研究。已经研究了许多不同的方法：细胞毒性和细胞生长抑制剂的联合使用以及分子靶向治疗都取得了一些令人鼓舞的结果。TMZ进一步强化方案以及术后局部应用负载卡莫司汀的缓释聚合物仍有待确定。因此，分子标志物的特征对于患者分层变得尤为重要，这增加了个性化治疗的可能性。
