Departments of1Neurosurgery.
2Oncology.
J Neurosurg. 2018 Feb;128(2):414-421. doi: 10.3171/2016.9.JNS16452. Epub 2017 Feb 24.
OBJECTIVE Treatment for glioblastoma (GBM) remains largely unsuccessful, even with aggressive combined treatment via surgery, radiotherapy, and chemotherapy. Tumor treating fields (TTFs) are low-intensity, intermediate-frequency, alternating electric fields that have antiproliferative properties in vitro and in vivo. The authors provide an up-to-date review of the mechanism of action as well as preclinical and clinical data on TTFs. METHODS A systematic review of the literature was performed using the terms "tumor treating fields," "alternating electric fields," "glioblastoma," "Optune," "NovoTTF-100A," and "Novocure." RESULTS Preclinical and clinical data have demonstrated the potential efficacy of TTFs for treatment of GBM, leading to several pilot studies, clinical trials, and, in 2011, FDA approval for its use as salvage therapy for recurrent GBM and, in 2015, approval for newly diagnosed GBM. CONCLUSIONS Current evidence supports the use of TTFs as an efficacious, antimitotic treatment with minimal toxicity in patients with newly diagnosed and recurrent GBM. Additional studies are needed to further optimize patient selection, determine cost-effectiveness, and assess the full impact on quality of life.
目的:即使采用手术、放疗和化疗的联合强化治疗,胶质母细胞瘤(GBM)的治疗仍然基本无效。肿瘤治疗电场(TTF)是一种低强度、中频、交替的电场,具有体外和体内的抗增殖特性。作者提供了关于 TTF 的作用机制以及临床前和临床数据的最新综述。
方法:使用“肿瘤治疗电场”、“交替电场”、“胶质母细胞瘤”、“Optune”、“NovoTTF-100A”和“Novocure”等术语对文献进行系统回顾。
结果:临床前和临床数据表明 TTF 治疗 GBM 的潜在疗效,导致了几项试验性研究、临床试验,以及 2011 年 FDA 批准将其作为复发性 GBM 的挽救性治疗,2015 年批准用于新诊断的 GBM。
结论:目前的证据支持 TTF 作为一种有效的抗有丝分裂治疗方法,对新诊断和复发性 GBM 患者的毒性最小。需要进一步的研究来进一步优化患者选择、确定成本效益,并评估对生活质量的全面影响。
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