新辅助治疗在提高“不可切除”脑胶质瘤切除程度中的作用。
The Role of Neoadjuvant Therapy to Improve the Extent of Resection in "Unresectable" Gliomas.
机构信息
Department of Surgical Neuro-Oncology, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Department of Surgical Neuro-Oncology, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
出版信息
World Neurosurg. 2021 Feb;146:53-58. doi: 10.1016/j.wneu.2020.10.109. Epub 2020 Oct 31.
BACKGROUND
Surgical resection plays a pivotal role in the management of glial tumors and a greater extent of resection (EOR) should be the goal in most surgeries to improve overall survival. Many factors may limit the EOR. A potential role for preoperative chemotherapy to decrease the volume and/or infiltration of gliomas, thereby facilitating a safe radical resection, has been recently suggested. This review aims to provide an overview of the current state of neoadjuvant therapy in the field of glioma surgery.
METHODS
A systematic review was conducted according to PRISMA guidelines to identify articles of low- and high-grade gliomas that received neoadjuvant chemotherapy prior to surgery to improve the EOR from 2000 to 2020. Full-text articles that addressed this subject were included for evaluation.
RESULTS
Case reports and clinical trials have been published for the use of chemotherapy as a neoadjuvant therapy to improve surgical resection in low-grade gliomas. More scarce information exists regarding this strategy for high-grade glioma surgery.
CONCLUSIONS
Neoadjuvant chemotherapy has played a role in overcoming obstacles that limit the EOR in patients with complex gliomas, especially low-grade gliomas.
背景
手术切除在神经胶质瘤的治疗中起着关键作用，大多数手术的目标是更大程度地切除肿瘤（EOR），以提高总体生存率。许多因素可能会限制 EOR。最近有人提出，术前化疗可能具有降低脑肿瘤体积和/或浸润程度的作用，从而有助于安全的根治性切除。本综述旨在概述神经胶质瘤手术领域新辅助治疗的现状。
方法
根据 PRISMA 指南进行系统评价，以确定从 2000 年到 2020 年接受新辅助化疗以提高 EOR 的低级别和高级别神经胶质瘤的文章。纳入全文评估的文章。
结果
已经发表了关于化疗作为新辅助治疗以改善低级别神经胶质瘤手术切除的病例报告和临床试验。对于高级别神经胶质瘤手术的这种策略，相关信息则较为匮乏。
结论
新辅助化疗在克服限制复杂神经胶质瘤 EOR 的障碍方面发挥了作用，尤其是在低级别神经胶质瘤中。
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