Barts Health NHS Trust, United Kingdom.
Barts Health NHS Trust, United Kingdom.
Clin Med (Lond). 2024 Sep;24(5):100240. doi: 10.1016/j.clinme.2024.100240. Epub 2024 Sep 2.
Primary brain tumours are rare but carry a significant morbidity and mortality burden. Malignant gliomas are the most common subtype and their incidence is increasing within our ageing population. The diagnosis and treatment of gliomas involves substantial interplay between multiple specialties, including general medical physicians, radiologists, pathologists, surgeons, oncologists and allied health professionals. At any point along this pathway, patients can present to acute medicine with complications of their cancer or anti-cancer therapy. Increasing the awareness of malignant gliomas among general physicians is paramount to delivering prompt radiological and histopathological diagnoses, facilitating access to earlier and individualised treatment options and allows for effective recognition and management of anticipated complications. This article discusses evidence-based real-world practice for malignant gliomas, encompassing patient presentation, diagnostic pathways, treatments and their complications, and prognosis to guide management outside of specialist centres.
原发性脑肿瘤较为罕见,但具有显著的发病率和死亡率负担。恶性神经胶质瘤是最常见的亚型,在我们的老龄化人口中其发病率正在增加。神经胶质瘤的诊断和治疗涉及多个专业之间的大量相互作用,包括普通内科医生、放射科医生、病理学家、外科医生、肿瘤学家和相关的医疗保健专业人员。在这条途径的任何一个环节,患者都可能因癌症或抗癌治疗的并发症而到急症医学就诊。提高普通内科医生对恶性神经胶质瘤的认识对于及时进行放射学和组织病理学诊断至关重要,有助于获得更早和个体化的治疗选择,并能够有效识别和处理预期的并发症。本文讨论了恶性神经胶质瘤的循证实际做法,包括患者就诊、诊断途径、治疗及其并发症和预后,以指导在专科中心之外的管理。