Delgado-López P D, Corrales-García E M
Servicio de Neurocirugía, Hospital Universitario de Burgos, Avda Islas Baleares 3, 09006, Burgos, Spain.
Servicio de Oncología Radioterápica, Hospital Universitario de Burgos, Avda Islas Baleares 3, 09006, Burgos, Spain.
Clin Transl Oncol. 2016 Nov;18(11):1062-1071. doi: 10.1007/s12094-016-1497-x. Epub 2016 Mar 10.
Glioblastoma (GBM) is the most common and lethal tumor of the central nervous system. The natural history of treated GBM remains very poor with 5-year survival rates of 5 %. Survival has not significantly improved over the last decades. Currently, the best that can be offered is a modest 14-month overall median survival in patients undergoing maximum safe resection plus adjuvant chemoradiotherapy. Prognostic factors involved in survival include age, performance status, grade, specific markers (MGMT methylation, mutation of IDH1, IDH2 or TERT, 1p19q codeletion, overexpression of EGFR, etc.) and, likely, the extent of resection. Certain adjuncts to surgery, especially cortical mapping and 5-ALA fluorescence, favor higher rates of gross total resection with apparent positive impact on survival. Recurrent tumors can be offered re-intervention, participation in clinical trials, anti-angiogenic agent or local electric field therapy, without an evident impact on survival. Molecular-targeted therapies, immunotherapy and gene therapy are promising tools currently under research.
胶质母细胞瘤（GBM）是中枢神经系统最常见且致命的肿瘤。接受治疗的GBM的自然病程仍然很差，5年生存率为5%。在过去几十年中，生存率并未显著提高。目前，对于接受最大安全切除加辅助放化疗的患者，所能达到的最佳总体中位生存期仅为适度的14个月。影响生存的预后因素包括年龄、体能状态、分级、特定标志物（MGMT甲基化、IDH1、IDH2或TERT突变、1p19q共缺失、EGFR过表达等），以及可能的切除范围。手术的某些辅助手段，特别是皮质图谱定位和5-氨基乙酰丙酸荧光技术，有利于提高全切除率，对生存有明显的积极影响。复发性肿瘤可进行再次干预、参加临床试验、使用抗血管生成药物或局部电场治疗，但对生存没有明显影响。分子靶向治疗、免疫治疗和基因治疗是目前正在研究的有前景的工具。
