Wank Michaela, Schilling Daniela, Schmid Thomas E, Meyer Bernhard, Gempt Jens, Barz Melanie, Schlegel Jürgen, Liesche Friederike, Kessel Kerstin A, Wiestler Benedikt, Bette Stefanie, Zimmer Claus, Combs Stephanie E
Institute of Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, 85764 Neuherberg, Germany.
Department of Radiation Oncology, Technical University of Munich (TUM), Klinikum rechts der Isar, 81675 Munich, Germany.
Cancers (Basel). 2018 Nov 20;10(11):456. doi: 10.3390/cancers10110456.
Gliomas are primary brain tumors that present the majority of malignant adult brain tumors. Gliomas are subdivided into low- and high-grade tumors. Despite extensive research in recent years, the prognosis of malignant glioma patients remains poor. This is caused by naturally highly infiltrative capacities as well as high levels of radio- and chemoresistance. Additionally, it was shown that low linear energy transfer (LET) irradiation enhances migration and invasion of several glioma entities which might counteract today's treatment concepts. However, this finding is discussed controversially. In the era of personalized medicine, this controversial data might be attributed to the patient-specific heterogeneity that ultimately could be used for treatment. Thus, current developments in glioma therapy should be seen in the context of intrinsic and radiation-enhanced migration and invasion. Due to the natural heterogeneity of glioma cells and different radiation responses, a personalized radiation treatment concept is suggested and alternative radiation concepts are discussed.
胶质瘤是主要的脑肿瘤，占大多数成人恶性脑肿瘤。胶质瘤可细分为低级别和高级别肿瘤。尽管近年来进行了广泛研究，但恶性胶质瘤患者的预后仍然很差。这是由其天然的高浸润能力以及高水平的放射和化学抗性导致的。此外，研究表明，低线性能量传递（LET）辐射会增强几种胶质瘤实体的迁移和侵袭能力，这可能与当今的治疗理念相悖。然而，这一发现存在争议。在个性化医疗时代，这些有争议的数据可能归因于患者特异性异质性，而这种异质性最终可用于治疗。因此，胶质瘤治疗的当前进展应结合其内在的以及辐射增强的迁移和侵袭情况来看待。由于胶质瘤细胞的天然异质性和不同的辐射反应，建议采用个性化放疗概念，并对替代放疗概念进行了讨论。
