Department of Neurosurgery, Xijing Institute of Clinical Neuroscience, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, PR China.
Crit Rev Oncol Hematol. 2013 Sep;87(3):265-82. doi: 10.1016/j.critrevonc.2013.01.007. Epub 2013 Feb 27.
Glioblastomas (GBMs) are invariably associated with unavoidable tumor recurrence and overall poor prognosis. The present study is to summarize the results of clinical Phase III studies on GBMs over the past seven years. A systematic literature search was performed using major electronic databases and by screening meeting abstracts. Totally, 16 studies of patients with newly diagnosed GBMs, recurrent GBMs, and elderly patients with GBMs were selected for this review. Although the outcomes of the experimental therapies were not encouraging, these studies produced a considerable amount of potentially clinically relevant information. Such aspects as surgical outcomes, radiation schedules, temozolomide (TMZ) schedules, methylation status of the O6-methylguanine DNA methyltransferase (MGMT) gene, combination of therapies, novel drug delivery methods and use of targeted agents have come to light and are being addressed here. In addition, we discuss the existing controversies of (1) surgical studies, (2) evaluations of recurrence, (3) salvage treatment bias, and (4) studies on elderly patients.
胶质母细胞瘤（GBM）总是与不可避免的肿瘤复发和总体预后不良相关。本研究总结了过去七年中 GBM 的临床 III 期研究结果。通过主要电子数据库和会议摘要筛选进行了系统的文献检索。共选择了 16 项新诊断 GBM、复发性 GBM 和老年 GBM 患者的研究进行综述。尽管实验治疗的结果并不令人鼓舞，但这些研究提供了大量潜在的临床相关信息。手术结果、放疗方案、替莫唑胺（TMZ）方案、O6-甲基鸟嘌呤 DNA 甲基转移酶（MGMT）基因甲基化状态、联合治疗、新型药物递送方法和靶向药物的使用等方面的信息已经浮出水面，并在这里进行了讨论。此外，我们还讨论了（1）手术研究、（2）复发评估、（3）挽救治疗偏倚和（4）老年患者研究中的现有争议。
