Tanaka Shota
Department of Neurosurgery, Tokyo University.
No Shinkei Geka. 2021 May;49(3):623-631. doi: 10.11477/mf.1436204436.
Glioblastoma, the most malignant and most common form of glioma, is known to portend very poor prognosis with the median overall survival of approximately 1.5 years. Its treatment requires a multidisciplinary approach, which consists of maximal safe resection followed by radiotherapy and chemotherapy with temozolomide. Bevacizumab is approved for newly diagnosed as well as recurrent malignant glioma in Japan. NovoTTF is a novel medical device that emits alternating electric fields; it inhibits the proliferation and growth of the tumor by interfering with tumor cell mitosis at anaphase. A photodynamic therapy with talaporfin sodium has been approved for primary malignant brain tumor including glioblastoma in Japan. For epilepsy secondary to glioblastoma, a novel class of antiepileptics such as levetiracetam and lacosamide is preferred given the lack of drug-drug interactions. Perampanel is a selective antagonist of AMPA receptors, the major subtype of ionotropic glutamate receptors; it may be a preferred antiepileptics for glioblastoma, given the and analyses suggesting that it decreases the proliferation and invasion of tumor cells. In this chapter, I describe the overview of the multidisciplinary treatments of glioblastoma. I also describe the future perspectives.
胶质母细胞瘤是最恶性且最常见的胶质瘤形式,已知其预后极差,中位总生存期约为1.5年。其治疗需要多学科方法,包括最大程度的安全切除,随后进行放疗和替莫唑胺化疗。贝伐单抗在日本被批准用于新诊断以及复发性恶性胶质瘤。NovoTTF是一种新型医疗设备,可发射交变电场;它通过在后期干扰肿瘤细胞有丝分裂来抑制肿瘤的增殖和生长。在日本,用他拉泊芬钠进行的光动力疗法已被批准用于包括胶质母细胞瘤在内的原发性恶性脑肿瘤。对于胶质母细胞瘤继发的癫痫,鉴于缺乏药物相互作用,首选新型抗癫痫药如左乙拉西坦和拉科酰胺。吡仑帕奈是离子型谷氨酸受体的主要亚型AMPA受体的选择性拮抗剂;鉴于相关分析表明它可降低肿瘤细胞的增殖和侵袭,它可能是胶质母细胞瘤的首选抗癫痫药。在本章中,我将描述胶质母细胞瘤多学科治疗的概述。我还将描述未来的前景。