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弥漫性胶质瘤的管理

Management of diffuse glioma.

作者信息

Esparragosa Inés, Díez-Valle Ricardo, Tejada Sonia, Gállego Pérez-Larraya Jaime

机构信息

University Clinic of Navarra, Department of Neurology, Avda. Pío XII, 36, 31008 Pamplona, Spain.

University Clinic of Navarra, Department of Neurosurgery, Avda. Pío XII, 36, 31008 Pamplona, Spain.

出版信息

Presse Med. 2018 Nov-Dec;47(11-12 Pt 2):e199-e212. doi: 10.1016/j.lpm.2018.04.014. Epub 2018 Oct 29.

Abstract

Diffuse gliomas constitute a diverse group of malignant brain tumors with varying aggressive course and heterogeneous survival. Although the mainstay of treatment of these distinct tumors is still based on the combination of surgery and classical therapeutic weapons such as radiotherapy and chemotherapy, important advances have been achieved over the past decades leading to meaningful improvements in survival times. In addition, recent progress in molecular profiling has allowed the identification of patients with better prognosis and more likely to respond to specific antitumor treatment. This is particularly true for grade II and III 1p/19q-codeleted gliomas, a subset of tumors in which data maturation after long-term follow-up have proved extremely important for accurate assessment of efficacy. This article aims at providing a review of the current specific antitumor treatment of diffuse glioma, particularly grade II and III glioma and glioblastoma, with special emphasis on the most relevant clinical trials conducted in these populations of patients.

摘要

弥漫性胶质瘤是一组多样的恶性脑肿瘤,其侵袭过程各异,生存期也不尽相同。尽管这些不同肿瘤的主要治疗方法仍基于手术与放疗、化疗等传统治疗手段的联合,但在过去几十年里已取得了重要进展,使生存时间有了显著改善。此外,分子谱分析的最新进展使得能够识别出预后较好且更可能对特定抗肿瘤治疗产生反应的患者。对于II级和III级1p/19q共缺失型胶质瘤尤其如此,在这类肿瘤亚组中,长期随访后的数据成熟对于准确评估疗效极为重要。本文旨在综述弥漫性胶质瘤,特别是II级和III级胶质瘤以及胶质母细胞瘤当前的特异性抗肿瘤治疗方法,特别强调在这些患者群体中开展的最相关的临床试验。

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