在2型神经纤维瘤病性神经鞘瘤中合理联合抗血管内皮生长因子（VEGF）治疗与放射治疗。
Rationally combining anti-VEGF therapy with radiation in NF2 schwannoma.
作者信息
Zhang Na, Gao Xing, Zhao Yingchao, Datta Meenal, Liu Pinan, Xu Lei
机构信息
Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 ; Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing China, 100730.
Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 ; Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
出版信息
J Rare Dis Res Treat. 2016;1(2):51-55.
Neurofibromatosis type 2 is characterized by bilateral vestibular schwannomas, which are benign tumors that originate from the nerve sheath and damage the nerve as they grow, causing neurological dysfunction such as hearing loss. Current standard radiation therapy can further augment hearing loss by inducing local damage to mature nerve tissue. Treatment with bevacizumab, a Vascular Endothelial Growth Factor (VEGF)-specific antibody, is associated with tumor control and hearing improvement in NF2 patients; however, its effect is not durable and its mechanism of action on improving nerve function is unknown. Anti-VEGF treatment can normalize the tumor vasculature, improving vessel perfusion and delivery of oxygen. It is known that oxygen is a potent radiosensitizer; therefore, combining anti-VEGF treatment with radiation therapy can achieve better tumor control and allow for the use of lower radiation doses, thus minimizing treatment-related neurological toxicity.
2型神经纤维瘤病的特征是双侧前庭神经鞘瘤，这些是起源于神经鞘的良性肿瘤，在生长过程中会损害神经，导致听力丧失等神经功能障碍。目前的标准放射治疗可通过对成熟神经组织造成局部损伤进一步加重听力丧失。使用贝伐单抗（一种血管内皮生长因子（VEGF）特异性抗体）进行治疗与2型神经纤维瘤病患者的肿瘤控制和听力改善相关；然而，其效果并不持久，其改善神经功能的作用机制尚不清楚。抗VEGF治疗可使肿瘤血管正常化，改善血管灌注和氧气输送。已知氧气是一种有效的放射增敏剂；因此，将抗VEGF治疗与放射治疗相结合可实现更好的肿瘤控制，并允许使用较低的放射剂量，从而将与治疗相关的神经毒性降至最低。
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