Rončević Alen, Koruga Nenad, Soldo Koruga Anamarija, Rončević Robert, Rotim Tatjana, Šimundić Tihana, Kretić Domagoj, Perić Marija, Turk Tajana, Štimac Damir
Department of Neurosurgery, University Hospital Center Osijek, 31000 Osijek, Croatia.
Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia.
Biomedicines. 2023 May 30;11(6):1579. doi: 10.3390/biomedicines11061579.
Glioblastoma (GBM) is the most aggressive glial tumor of the central nervous system. Despite intense scientific efforts, patients diagnosed with GBM and treated with the current standard of care have a median survival of only 15 months. Patients are initially treated by a neurosurgeon with the goal of maximal safe resection of the tumor. Obtaining tissue samples during surgery is indispensable for the diagnosis of GBM. Technological improvements, such as navigation systems and intraoperative monitoring, significantly advanced the possibility of safe gross tumor resection. Usually within six weeks after the surgery, concomitant radiotherapy and chemotherapy with temozolomide are initiated. However, current radiotherapy regimens are based on population-level studies and could also be improved. Implementing artificial intelligence in radiotherapy planning might be used to individualize treatment plans. Furthermore, detailed genetic and molecular markers of the tumor could provide patient-tailored immunochemotherapy. In this article, we review current standard of care and possibilities of personalizing these treatments. Additionally, we discuss novel individualized therapeutic options with encouraging results. Due to inherent heterogeneity of GBM, applying patient-tailored treatment could significantly prolong survival of these patients.
胶质母细胞瘤（GBM）是中枢神经系统中最具侵袭性的神经胶质瘤。尽管进行了大量科学研究，但被诊断为GBM并接受当前标准治疗的患者中位生存期仅为15个月。患者最初由神经外科医生进行治疗，目标是最大程度地安全切除肿瘤。手术期间获取组织样本对于GBM的诊断必不可少。诸如导航系统和术中监测等技术进步显著提高了安全切除肿瘤大体组织的可能性。通常在手术后六周内，开始同步进行放疗和替莫唑胺化疗。然而，目前的放疗方案是基于群体水平的研究，也还有改进的空间。在放疗计划中应用人工智能可能用于使治疗计划个性化。此外，肿瘤详细的基因和分子标记可为患者量身定制免疫化疗。在本文中，我们回顾了当前的治疗标准以及使这些治疗个性化的可能性。此外，我们还讨论了取得了令人鼓舞结果的新型个体化治疗选择。由于GBM固有的异质性，采用针对患者的定制治疗可显著延长这些患者的生存期。
