Nguyen Nam P, Nguyen Mai L, Vock Jacqueline, Lemanski Claire, Kerr Christine, Vinh-Hung Vincent, Chi Alexander, Khan Rihan, Woods William, Altdorfer Gabor, D'Andrea Mark, Karlsson Ulf, Hamilton Russ, Ampil Fred
Department of Radiation Oncology, The University of Arizona , Tucson, AZ , USA.
Front Oncol. 2013 Nov 19;3:284. doi: 10.3389/fonc.2013.00284.
Treatment of glioblastoma multiforme (GBM) and brain metastasis remains a challenge because of the poor survival and the potential for brain damage following radiation. Despite concurrent chemotherapy and radiation dose escalation, local recurrence remains the predominant pattern of failure in GBM most likely secondary to repopulation of cancer stem cells. Even though radiotherapy is highly effective for local control of radio-resistant tumors such as melanoma and renal cell cancer, systemic disease progression is the cause of death in most patients with brain metastasis. Preservation of quality of life (QOL) of cancer survivors is the main issue for patients with brain metastasis. Image-guided radiotherapy (IGRT) by virtue of precise radiation dose delivery may reduce treatment time of patients with GBM without excessive toxicity and potentially improve neurocognitive function with preservation of local control in patients with brain metastasis. Future prospective trials for primary brain tumors or brain metastasis should include IGRT to assess its efficacy to improve patient QOL.
多形性胶质母细胞瘤（GBM）和脑转移瘤的治疗仍然是一项挑战，这是因为患者生存率低，且放疗后存在脑损伤的可能性。尽管同时进行化疗和增加放疗剂量，但局部复发仍是GBM最主要的失败模式，这很可能继发于癌症干细胞的再增殖。尽管放射疗法对黑色素瘤和肾细胞癌等放射抗性肿瘤的局部控制非常有效，但全身疾病进展仍是大多数脑转移瘤患者的死亡原因。对于脑转移瘤患者而言，维持癌症幸存者的生活质量（QOL）是主要问题。图像引导放射治疗（IGRT）凭借精确的放射剂量递送，可能会减少GBM患者的治疗时间，且不会产生过度毒性，并有可能在维持脑转移瘤患者局部控制的同时改善神经认知功能。未来针对原发性脑肿瘤或脑转移瘤的前瞻性试验应纳入IGRT，以评估其改善患者QOL的疗效。
