Wang Yaning, Zhao Binghao, Chen Wanqi, Liu Lei, Chen Wenlin, Zhou Lizhou, Kong Ziren, Dai Congxin, Wang Yu, Ma Wenbin
Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Aging Dis. 2020 Mar 9;11(2):448-461. doi: 10.14336/AD.2019.0527. eCollection 2020 Apr.
Glioma is the most frequent primary brain tumor affecting adults, and the most lethal type is glioblastoma (GBM); currently, the available therapies only provide palliation. The treatments for low-grade glioma (LGG) include neurosurgical resection, watchful waiting, radiotherapy and chemotherapy, while the therapeutic strategies for high-grade glioma (HGG), particularly in elderly patients, have evolved to include radiotherapy, chemotherapy, and targeted monotherapy based on the characteristics of the investigated patients. Proper assessments aiming to predict and achieve the most satisfying prognosis among patients prior to surgery, radiotherapy, chemotherapy, targeted therapy or immunotherapy help summarize the pretreatment characteristics of patients, providing doctors comprehensive information to consider while determining whether the patients could benefit from ongoing treatments and deciding the proper treatment strategy for subsequent phases. This article aims to rigorously review the most recent evidence and discuss current mainstream assessments before the initiation of proper treatments for glioma, thus highlighting the potential necessity of pretreatment assessments.
胶质瘤是影响成年人的最常见原发性脑肿瘤,最致命的类型是胶质母细胞瘤(GBM);目前,可用的治疗方法仅能提供姑息治疗。低级别胶质瘤(LGG)的治疗包括神经外科手术切除、观察等待、放疗和化疗,而高级别胶质瘤(HGG)的治疗策略,特别是在老年患者中,已发展为包括放疗、化疗以及基于所研究患者特征的靶向单一疗法。在手术、放疗、化疗、靶向治疗或免疫治疗之前,进行适当评估以预测并实现患者中最满意的预后,有助于总结患者的预处理特征,为医生在确定患者是否能从正在进行的治疗中获益以及决定后续阶段的适当治疗策略时提供全面信息以供考虑。本文旨在严格审查最新证据,并讨论在开始对胶质瘤进行适当治疗之前的当前主流评估,从而突出预处理评估的潜在必要性。