Talibi Sayed Samed, Talibi Sayed Samie, Aweid Bashaar, Aweid Osama
University Hospital of North Staffordshire, Stoke-on-Trent, United Kingdom.
North Cumbria University Hospitals NHS Trust, Carlisle, United Kingdom.
Ann Med Surg (Lond). 2014 May 21;3(3):55-9. doi: 10.1016/j.amsu.2014.04.003. eCollection 2014 Sep.
After three decades of intensive research, cytoreductive surgery remains the gold standard of treatment of malignant gliomas. Survivorship at both 1-year and 5-years has not drastically changed in the UK. Concomitant chemo- and radiotherapy has enhanced the efficiency of surgery, enabling more aggressive tumour resection whilst also preserving the surrounding healthy brain parenchyma. More accurate imaging techniques have also played a role in tumour identification, key to this has been pre- and intra-operative contrast enhancement and compounds that have a high affinity in binding to glioma cells. Intra-operative imaging has heralded the ability to give the operating surgeon continuous feedback to assess the completeness of resection. Research is shifting into investigating the complex cellular and molecular glial tumour-genesis, and has led to the development of efficacious chemotherapy agents and trial novel therapies. Oncolytic virotherapy has shown promise in clinical trials and gene therapy in-vitro studies. Surgery however remains the primary therapeutic option for the management of malignant gliomas removing the mass of proliferating malignant tumour cells and decompression of the space-occupying lesion.
经过三十年的深入研究，减瘤手术仍然是恶性胶质瘤治疗的金标准。在英国，1年和5年生存率并未发生显著变化。同步放化疗提高了手术效率，使得在保留周围健康脑实质的同时能够更积极地切除肿瘤。更精确的成像技术也在肿瘤识别中发挥了作用，这方面的关键在于术前和术中的对比增强以及与胶质瘤细胞具有高亲和力的化合物。术中成像使手术医生能够获得连续反馈，以评估切除的完整性。研究正转向探究复杂的细胞和分子胶质肿瘤发生机制，并已促成了有效化疗药物的开发以及新型疗法的试验。溶瘤病毒疗法在临床试验中显示出前景，基因疗法在体外研究中也有成效。然而，手术仍然是治疗恶性胶质瘤的主要治疗选择，可切除增殖的恶性肿瘤细胞团并解除占位性病变的压迫。
