Department of Neurosurgery, Queen's Medical Centre, Nottingham, UK.
Br J Neurosurg. 2022 Oct;36(5):564-568. doi: 10.1080/02688697.2021.1886242. Epub 2021 Feb 13.
Alternating electrical field therapy represents a recent addition to the armamentarium against high grade glioma. Randomised trial evidence suggests a survival benefit from adjunctive scalp delivered Tumour Treating Fields (TTFields) in glioblastoma. Any underlying anti-glioma effect is not fully understood, but interference with cell division and microtubule assembly has been averred. The survival benefit claimed for TTFields is modest and is associated with mild reductions in health-related quality of life indices amid costs that presently preclude routine use. I review possible mechanisms by which alternating electrical fields may confer an anti-glioma effect. As scalp and skull are poor conductors of an electrical field, a case is made here for implantable electrodes, perhaps placed at the time of tumour debulking. Such a system may deliver an electrical field directly to the tumour resection cavity and with greater precision.
电场治疗是一种针对高级别脑胶质瘤的新方法。随机试验证据表明，辅助头皮肿瘤治疗电场（TTFields）可使胶质母细胞瘤患者受益。目前还不完全清楚其潜在的抗胶质瘤作用机制，但有观点认为它可以干扰细胞分裂和微管组装。TTFields 声称的生存获益是适度的，并且与健康相关的生活质量指数降低有关，而成本目前又阻碍了其常规使用。本文回顾了交变电场可能发挥抗胶质瘤作用的可能机制。由于头皮和颅骨对电场的传导性很差，因此这里提出了使用植入式电极的可能性，也许可以在肿瘤切除术时使用。这样的系统可以更精确地将电场直接传递到肿瘤切除腔。
