肿瘤治疗电场与联合疗法在脑肿瘤治疗中的应用

Tumor Treating Fields and Combination Therapy in Management of Brain Oncology.

作者信息

Liu Ruisi Nicole, Huang James H, Qi Xiaoming, Pan Yizhong, Wu Erxi, Nizamutdinov Damir

机构信息

Department of Neurosurgery and Neuroscience Institute, Baylor Scott & White Health, Temple, TX 76508, USA.

Department of Neurology, Baylor Scott & White Health, Temple, TX 76508, USA.

出版信息

Cancers (Basel). 2025 Apr 2;17(7):1211. doi: 10.3390/cancers17071211.

Abstract

Glioblastoma (GBM) remains a challenging cancer to treat with limited effective therapies. Standard treatments, including surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy, offer marginal survival benefits but are often limited by side effects and drug resistance. Temozolomide is the most commonly used chemotherapy; however, resistance and lack of efficacy in recurrent GBM hinder its success. Tumor treating fields (TTFields), a novel non-invasive modality that utilizes alternating electric fields, have recently emerged as a promising treatment for GBM. TTFields work by disrupting the function of the mitotic spindle and inducing apoptosis in cancer cells. They can be especially effective when combined with other therapies. TTFields enhance drug delivery when paired with chemotherapy by increasing the permeability of the blood-brain barrier and cell membranes, leading to more effective tumor inhibition. Similarly, TTFields increase cancer cell sensitivity to radiation therapy and improve the efficacy of targeted therapies, such as sorafenib and immunotherapy, particularly in extra-cranial tumors. The Optune device, the primary medical device for TTFields' delivery, offers a convenient and versatile treatment option, allowing remote care and exhibiting fewer adverse effects. This review discusses the potential of TTFields as a valuable addition to GBM treatment, particularly in combination therapies, and highlights the device's clinical applications.

摘要

胶质母细胞瘤(GBM)仍然是一种治疗具有挑战性的癌症,有效治疗方法有限。包括手术、放疗、化疗、靶向治疗和免疫治疗在内的标准治疗方法仅能带来有限的生存益处,且常常受到副作用和耐药性的限制。替莫唑胺是最常用的化疗药物;然而,复发性GBM中的耐药性和疗效不佳阻碍了其治疗效果。肿瘤治疗电场(TTFields)是一种利用交变电场的新型非侵入性治疗方式,最近已成为GBM的一种有前景的治疗方法。TTFields通过破坏有丝分裂纺锤体的功能并诱导癌细胞凋亡来发挥作用。当与其他疗法联合使用时,它们可能会特别有效。TTFields与化疗联合使用时,通过增加血脑屏障和细胞膜的通透性来增强药物递送,从而更有效地抑制肿瘤。同样,TTFields可提高癌细胞对放射治疗的敏感性,并提高靶向治疗(如索拉非尼)和免疫治疗的疗效,特别是在颅外肿瘤中。Optune设备是用于递送TTFields的主要医疗设备,提供了一种方便且通用的治疗选择,允许远程护理且不良反应较少。本综述讨论了TTFields作为GBM治疗中一种有价值的补充方法的潜力,特别是在联合治疗中,并强调了该设备的临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6803/11987984/cf0d21fec230/cancers-17-01211-g001.jpg

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