Wong Eric T, Lok Edwin, Swanson Kenneth D
Prog Neurol Surg. 2018;32:180-195. doi: 10.1159/000469690. Epub 2018 Jul 10.
Alternating electric fields of intermediate frequencies, also known as Tumor Treating Fields (TTFields or TTF) is a novel anticancer treatment modality that disrupts tumor cell mitosis at the metaphase-anaphase transition, leading to mitotic catastrophe, aberrant mitotic exit, and/or cell death. It is realized through alteration of the cytokinetic cleavage furrow by interference of proteins possessing large dipole moments, like septin heterotrimer complex and α/β-tubulin, and that results in disordered membrane contraction and failed cytokinesis. Aberrant mitotic exit also elicits immunogenic cell death, which may potentiate an immune response against treated tumors. Notably, in patients with recurrent glioblastoma multiforme (GBM) a prospective clinical trial demonstrated comparable overall survival and progression-free survival after TTFields therapy and best physician's choice chemotherapy. Moreover, it was shown that in patients with newly diagnosed GBM initially treated with standard chemoradiotherapy with daily temozolomide (TMZ), adjuvant TTFields combined with TMZ offered better survival than adjuvant TMZ alone. Therefore, TTFields therapy can be appreciated as a standard treatment option in cases of intracranial malignant gliomas, whereas future studies should establish its optimal combination with other existing anticancer modalities, which may offer additional survival benefits for patients.
中频交变电场，也称为肿瘤治疗电场（TTFields 或 TTF），是一种新型抗癌治疗方式，它在中期 - 后期转变阶段破坏肿瘤细胞有丝分裂，导致有丝分裂灾难、异常的有丝分裂退出和/或细胞死亡。它是通过干扰具有大偶极矩的蛋白质（如 septin 异源三聚体复合物和α/β - 微管蛋白）来改变细胞动力学分裂沟而实现的，这会导致膜收缩紊乱和胞质分裂失败。异常的有丝分裂退出还会引发免疫原性细胞死亡，这可能增强针对治疗肿瘤的免疫反应。值得注意的是，在复发性多形性胶质母细胞瘤（GBM）患者中，一项前瞻性临床试验表明，TTFields 治疗与最佳医生选择的化疗后的总生存期和无进展生存期相当。此外，研究表明，在最初接受每日替莫唑胺（TMZ）标准放化疗的新诊断 GBM 患者中，辅助 TTFields 联合 TMZ 比单独辅助 TMZ 提供了更好的生存期。因此，TTFields 治疗可被视为颅内恶性胶质瘤病例的标准治疗选择，而未来的研究应确定其与其他现有抗癌方式的最佳组合，这可能为患者带来额外的生存益处。
