Columbia University Irving Medical Center, New York, NY, 10032, USA.
Department of Neurosurgery, Columbia University Irving Medical Center, New York, NY, 10032, USA.
Adv Exp Med Biol. 2023;1405:1-30. doi: 10.1007/978-3-031-23705-8_1.
This chapter provides a comprehensive overview of malignant gliomas, the most common primary brain tumor in adults. These tumors are varied in their cellular origin, genetic profile, and morphology under the microscope, but together they share some of the most dismal prognoses of all neoplasms in the body. Although there is currently no cure for malignant glioma, persistent efforts to improve outcomes in patients with these tumors have led to modest increases in survival, and researchers worldwide continue to strive toward a deeper understanding of the factors that influence glioma development and response to treatment. In addition to well-established epidemiology, clinical manifestations, and common histopathologic and radiologic features of malignant gliomas, this section considers recent advances in molecular biology that have led to a more nuanced understanding of the genetic changes that characterize the different types of malignant glioma, as well as their implications for treatment. Beyond the traditional classification of malignant gliomas based on histopathological features, this chapter incorporates the World Health Organization's 2016 criteria for the classification of brain tumors, with special focus on disease-defining genetic alterations and newly established subcategories of malignant glioma that were previously unidentifiable based on microscopic examination alone. Traditional therapeutic modalities that form the cornerstone of treatment for malignant glioma, such as aggressive surgical resection followed by adjuvant chemotherapy and radiation therapy, and the studies that support their efficacy are reviewed in detail. This provides a foundation for additional discussion of novel therapeutic methods such as immunotherapy and convection-enhanced delivery, as well as new techniques for enhancing extent of resection such as fluorescence-guided surgery.
这一章全面概述了恶性胶质瘤,这是成人中最常见的原发性脑肿瘤。这些肿瘤在细胞起源、遗传特征和显微镜下的形态上各不相同,但它们都具有所有体内肿瘤中最恶劣的预后。尽管目前还没有治愈恶性胶质瘤的方法,但持续努力改善这些肿瘤患者的预后,导致患者的生存率略有提高,世界各地的研究人员继续努力深入了解影响胶质瘤发展和对治疗反应的因素。除了恶性胶质瘤的已确立的流行病学、临床表现以及常见的组织病理学和影像学特征外,这一节还考虑了分子生物学的最新进展,这些进展导致对特征不同类型恶性胶质瘤的遗传变化有了更细致的理解,以及这些变化对治疗的影响。除了基于组织病理学特征的恶性胶质瘤传统分类外,本章还采用了世界卫生组织 2016 年的脑肿瘤分类标准,特别关注疾病定义性的遗传改变以及以前仅通过显微镜检查无法识别的新设立的恶性胶质瘤亚类。详细回顾了作为恶性胶质瘤治疗基石的传统治疗方式,如积极的手术切除,然后辅助化疗和放疗,以及支持其疗效的研究。这为进一步讨论免疫疗法和对流增强递送等新的治疗方法以及增强切除范围的新技术(如荧光引导手术)提供了基础。
Adv Exp Med Biol. 2023
Adv Exp Med Biol. 2023
Can J Neurol Sci. 2020-7
Gan To Kagaku Ryoho. 1986-1
Curr Treat Options Oncol. 2000-12
R I Med J (2013). 2017-6-1
Nervenarzt. 2018-6
Appl Biochem Biotechnol. 2025-9-2
Cancers (Basel). 2025-8-14
Front Public Health. 2025-7-18
Int J Mol Sci. 2025-6-27
Int J Nanomedicine. 2025-4-28
J Surg Oncol. 2018-8
CNS Oncol. 2018-1
Neurotherapeutics. 2017-4
Seizure. 2017-1
Curr Neuropharmacol. 2017
CNS Oncol. 2015
Curr Oncol. 2015-8