Duffau H
Department of Neurosurgery, Gui-de-Chauliac Hospital, Montpellier University Medical Center, 80, avenue Augustin-Fliche, 34295 Montpellier, France; National Institute for Health and Medical Research (Inserm), U1051 Laboratory, Team "Brain Plasticity, Stem Cells and Glial Tumors", Institute for Neurosciences of Montpellier, Montpellier University Medical Center, 34091 Montpellier, France.
Diagn Interv Imaging. 2014 Oct;95(10):945-55. doi: 10.1016/j.diii.2014.08.001. Epub 2014 Sep 16.
The traditional approach in neuro-oncology is to study the tumor in great detail and ultimately give little consideration to the brain itself. Choosing the best treatment strategy for each patient with a diffuse low-grade glioma, in other words optimizing the oncologic and functional balance, implies not only a full knowledge of the natural history of this chronic disease, but also an understanding of the adaptation of the brain in response to growth and spread of the glioma. The aim of this review is to examine the mechanisms underlying this neuroplasticity, allowing functional compensation when the tumor progresses, and opening the way to new treatments with the principle of shifting towards "functional personalized neuro-oncology", improving both median survival and quality of life.
神经肿瘤学的传统方法是深入研究肿瘤,而最终很少考虑大脑本身。为每位弥漫性低级别胶质瘤患者选择最佳治疗策略,换句话说就是优化肿瘤学与功能之间的平衡,这不仅意味着要全面了解这种慢性疾病的自然史,还意味着要理解大脑对胶质瘤生长和扩散的适应性反应。本综述的目的是研究这种神经可塑性背后的机制,在肿瘤进展时实现功能代偿,并为朝着“功能性个性化神经肿瘤学”原则发展的新治疗方法开辟道路,从而提高中位生存期和生活质量。