Forst Deborah A, Nahed Brian V, Loeffler Jay S, Batchelor Tracy T
Departments of Neurology, Neurosurgery, and Radiation Oncology, and Division of Hematology and Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Oncologist. 2014 Apr;19(4):403-13. doi: 10.1634/theoncologist.2013-0345. Epub 2014 Mar 24.
Low-grade gliomas (LGGs) are a diverse group of primary brain tumors that often arise in young, otherwise healthy patients and generally have an indolent course with longer-term survival in comparison with high-grade gliomas. Treatment options include observation, surgery, radiation, chemotherapy, or a combined approach, and management is individualized based on tumor location, histology, molecular profile, and patient characteristics. Moreover, in this type of brain tumor with a relatively good prognosis and prolonged survival, the potential benefits of treatment must be carefully weighed against potential treatment-related risks. We review in this article current management strategies for LGG, including surgery, radiotherapy, and chemotherapy. In addition, the importance of profiling the genetic and molecular properties of LGGs in the development of targeted anticancer therapies is also reviewed. Finally, given the prevalence of these tumors in otherwise healthy young patients, the impact of treatment on neurocognitive function and quality of life is also evaluated.
低级别胶质瘤(LGGs)是一组多样的原发性脑肿瘤,常发生于年轻的、其他方面健康的患者,与高级别胶质瘤相比,其病程通常较为缓慢,生存期较长。治疗选择包括观察、手术、放疗、化疗或联合治疗方法,治疗方案根据肿瘤位置、组织学、分子特征和患者特征进行个体化制定。此外,对于这种预后相对较好且生存期延长的脑肿瘤类型,必须仔细权衡治疗的潜在益处与潜在的治疗相关风险。我们在本文中综述了LGG的当前管理策略,包括手术、放疗和化疗。此外,还综述了在开发靶向抗癌疗法中分析LGGs遗传和分子特性的重要性。最后,鉴于这些肿瘤在其他方面健康的年轻患者中的患病率,还评估了治疗对神经认知功能和生活质量的影响。