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肿瘤治疗电场(TTFields)治疗合并多发性硬化症的胶质母细胞瘤的首例报告

First Report of Tumor Treating Fields (TTFields) Therapy for Glioblastoma in Comorbidity with Multiple Sclerosis.

作者信息

Kassubek Rebecca, Mathieu René

机构信息

Department of Neurology, University of Ulm, 89081 Ulm, Germany.

Department of Neurosurgery, German Federal Armed Forces Hospital Ulm, 89081 Ulm, Germany.

出版信息

Brain Sci. 2022 Apr 13;12(4):499. doi: 10.3390/brainsci12040499.

Abstract

Tumor Treating Fields (TTFields) therapy is FDA approved and has the CE mark for treatment of newly diagnosed and recurrent glioblastoma. To our knowledge, to date TTFields therapy remains unstudied in glioblastoma patients with multiple sclerosis (MS) as a comorbidity. Here, we present a patient who was diagnosed with MS at the age of 34. Treatment included several corticoid pulse treatments and therapies with interferon beta-1a and sphingosine-1-phosphate receptor modulator fingolimod. At the age of 52 the patient was diagnosed with glioblastoma, after experiencing worsening headaches which could not be attributed to the MS condition. After subtotal resection and concomitant radiochemotherapy, the patient received temozolomide in combination with TTFields therapy. For two years, the tumor condition remained stable while the patient showed high adherence to TTFields therapy with low-grade skin reactions being the only therapy-related adverse events. After two years, the tumor recurred. The patient underwent re-resection and radiotherapy and restarted TTFields therapy together with chemotherapy and is currently still on this therapy regime. Although having not been studied systematically, the case presented here demonstrates that TTFields therapy may be considered for newly diagnosed and recurrent glioblastoma patients with previously diagnosed multiple sclerosis.

摘要

肿瘤治疗电场(TTFields)疗法已获美国食品药品监督管理局(FDA)批准,并具有用于治疗新诊断和复发性胶质母细胞瘤的CE标志。据我们所知,迄今为止,TTFields疗法在患有多发性硬化症(MS)合并症的胶质母细胞瘤患者中尚未得到研究。在此,我们报告一名34岁时被诊断为MS的患者。治疗包括多次皮质类固醇脉冲治疗以及使用β-1a干扰素和鞘氨醇-1-磷酸受体调节剂芬戈莫德进行的治疗。52岁时,该患者在经历了无法归因于MS病情的头痛加重后,被诊断为胶质母细胞瘤。在次全切除并同步进行放化疗后,患者接受了替莫唑胺联合TTFields疗法。两年来,肿瘤病情保持稳定,同时患者对TTFields疗法的依从性很高,仅出现轻度皮肤反应这一与治疗相关的不良事件。两年后,肿瘤复发。患者接受了再次切除和放疗,并重新开始TTFields疗法以及化疗,目前仍处于该治疗方案中。尽管尚未进行系统研究,但此处报告的病例表明,对于先前诊断为多发性硬化症的新诊断和复发性胶质母细胞瘤患者,可以考虑使用TTFields疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6980/9032427/ed61ed1011a0/brainsci-12-00499-g001.jpg

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