Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL..
Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL.
Semin Radiat Oncol. 2020 Jul;30(3):218-222. doi: 10.1016/j.semradonc.2020.02.005.
Treatment of recurrent gliomas is especially challenging, as many of these patients have previously been treated with extensive surgery, radiation, or systemic therapy. Due to this, the optimum therapy for patients with recurrent glioma is controversial, with widely variable practice patterns. In this opinion piece, a multidisciplinary panel of experts provides rationale for their treatment approach in a patient with recurrent glioma following subtotal resection with adjuvant chemoradiation for an anaplastic astrocytoma. In summary, the consensus of the panel was to recommend re-resection if possible with hypofractionated radiotherapy schedules, with re-irradiation and systemic therapy as directed by a multidisciplinary team through repeat analysis of the tumor specimen for an updated mutational burden.
治疗复发性神经胶质瘤尤其具有挑战性，因为这些患者中的许多人之前已经接受了广泛的手术、放疗或全身治疗。因此，对于复发性神经胶质瘤患者的最佳治疗方法存在争议，实践模式差异很大。在这篇观点文章中，一组多学科专家小组为一名接受次全切除和辅助放化疗治疗间变性星形细胞瘤后出现复发性神经胶质瘤的患者提供了他们的治疗方法的基本原理。总之，专家组的共识是建议尽可能进行再次切除，如果可行，采用分次放疗方案，并根据肿瘤标本的再次分析结果，由多学科团队决定是否进行再次放疗和全身治疗，以更新突变负担。
