Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas, USA.
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA; Department of Neurosurgery, MD Anderson Cancer Center, Houston, Texas, USA.
World Neurosurg. 2019 Nov;131:65-75. doi: 10.1016/j.wneu.2019.07.096. Epub 2019 Jul 16.
Glioblastoma is the most common intracranial malignancy in adults and carries a poor prognosis. Chemotherapeutic treatment figures prominently in the management of primary and recurrent disease. However, the blood-brain barrier presents a significant and formidable impediment to the entry of oncotherapeutic compounds to target tumor tissue. Several strategies have been developed to effect disruption of the blood-brain barrier and in turn enhance the efficacy of cytotoxic chemotherapy, as well as newly developed biologic agents. Focused ultrasonography is one such treatment modality, using acoustic cavitation of parenterally administered microbubbles to mechanically effect disruption of the vascular endothelium. We review and discuss the preclinical and clinical studies evaluating the biophysical basis for, and efficacy of, focused ultrasonography in the enhancement of oncotherapeutic agent delivery. Further, we provide some perspectives regarding future directions for the role of focused ultrasound in facilitating and improving the safe and effective delivery of oncotherapeutic agents in the treatment of glioblastoma.
胶质母细胞瘤是成人中最常见的颅内恶性肿瘤,预后不良。化学治疗在原发性和复发性疾病的治疗中占有重要地位。然而,血脑屏障对进入肿瘤组织的肿瘤治疗化合物构成了重大而严峻的障碍。已经开发了几种策略来破坏血脑屏障,从而提高细胞毒性化疗以及新开发的生物制剂的疗效。聚焦超声是一种这样的治疗方式,使用静脉内给予的微泡的声空化来机械地破坏血管内皮。我们回顾和讨论了评估聚焦超声增强肿瘤治疗剂递送的生物学基础和疗效的临床前和临床研究。此外,我们还对聚焦超声在促进和改善胶质母细胞瘤治疗中肿瘤治疗剂安全有效递送上的作用的未来方向提供了一些观点。
Drug Resist Updat. 2015-3-6