Hayhurst Caroline
Department of Neurosurgery, University Hospital of Wales, Cardiff, UK.
Pract Neurol. 2017 Jun;17(3):183-190. doi: 10.1136/practneurol-2017-001604. Epub 2017 Mar 18.
Supratentorial diffuse intrinsic low-grade gliomas represent a distinct but heterogenous group of tumours, with the propensity to grow and to differentiate into malignant tumours. They have been historically viewed in the 'benign' spectrum of intrinsic brain tumours, so a watch-and-wait policy was often adopted. With recent advances in our understanding of the natural history of these tumours, combined with advances in surgical technique, an aggressive approach is now recommended. Increasing quality evidence of the impact of tumour resection and multicentre trials of adjuvant radiotherapy and chemotherapy have led to a new algorithm for low-grade glioma management. This review aims to outline the emerging evidence that has shifted neuro-oncology practice.
幕上弥漫性固有低级别胶质瘤是一组独特但异质性的肿瘤,有生长并分化为恶性肿瘤的倾向。在历史上,它们一直被视为固有脑肿瘤中的“良性”类型,因此常采取观察等待策略。随着我们对这些肿瘤自然史认识的最新进展,再加上手术技术的进步,现在推荐采取积极的治疗方法。肿瘤切除影响的高质量证据不断增加以及辅助放疗和化疗的多中心试验,催生了一种新的低级别胶质瘤管理算法。本综述旨在概述已改变神经肿瘤学实践的新证据。