Department of Neurology, Neuro-Oncology Program, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA.
Semin Oncol. 2011 Dec;38 Suppl 4:S11-20. doi: 10.1053/j.seminoncol.2011.09.007.
Glioblastoma is an aggressive form of brain cancer with a poor long-term prognosis. Treatment regimens for newly diagnosed disease range from surgical resection alone to surgery followed by radiotherapy with concurrent and adjuvant chemotherapy. Ongoing investigations are focused on optimization of chemotherapy by improving dosing and duration schedules and utilization of biomarkers for patient selection. Our understanding of glioblastoma tumor biology, the role of molecular signaling pathways, cellular repair mechanisms, and angiogenesis has increased greatly over the past few years, leading to the investigation of a variety of targeted therapies. In addition, advances in radiographic assessment have significantly impacted not only improvement in diagnosis, but interpretation of response to therapy. In order to effectively evaluate the clinical utility of new agents, as well as incorporate advances in radiographic assessment, changes to current clinical trial design need to be considered. This article reviews the care for newly diagnosed glioblastoma, as well as how recent findings might be incorporated into patient care.
胶质母细胞瘤是一种侵袭性脑癌，预后较差。新诊断疾病的治疗方案范围从单独手术切除到手术加放疗，同时进行和辅助化疗。目前的研究重点是通过改善剂量和持续时间方案以及利用生物标志物进行患者选择来优化化疗。在过去几年中，我们对胶质母细胞瘤肿瘤生物学、分子信号通路的作用、细胞修复机制和血管生成的理解有了很大的提高，从而导致了各种靶向治疗的研究。此外，影像学评估的进展不仅显著改善了诊断，而且还影响了对治疗反应的解读。为了有效地评估新药物的临床实用性，并结合影像学评估的进展，需要考虑对当前临床试验设计的更改。本文回顾了新诊断胶质母细胞瘤的治疗方法，以及最近的发现如何纳入患者的治疗。
