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加拿大胶质母细胞瘤诊断与管理专家共识建议:德尔菲研究结果

Canadian Expert Consensus Recommendations for the Diagnosis and Management of Glioblastoma: Results of a Delphi Study.

作者信息

Mason Warren P, Harrison Rebecca A, Lapointe Sarah, Lim-Fat Mary Jane, MacNeil Mary V, Mathieu David, Perry James R, Pitz Marshall W, Roberge David, Tsang Derek S, Tsien Christina, van Landeghem Frank K H, Zadeh Gelareh, Easaw Jacob

机构信息

Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 2M9, Canada.

Department of Medicine, University of British Columbia, Vancouver, BC V5Z 4E6, Canada.

出版信息

Curr Oncol. 2025 Apr 1;32(4):207. doi: 10.3390/curroncol32040207.


DOI:10.3390/curroncol32040207
PMID:40277764
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12026134/
Abstract

Glioblastoma is the most common and aggressive malignant brain tumor in adults, with an increasing incidence and a poor prognosis. Current challenges in glioblastoma management include rapid tumor growth, limited treatment effectiveness, high recurrence rates, and a significant impact on patients' quality of life. Given the complexity of glioblastoma care and recent advancements in diagnostic and treatment modalities, updated guidelines are needed in Canada. This Delphi study aimed to develop Canadian consensus recommendations for the diagnosis, classification, and management of newly diagnosed and recurrent glioblastoma. A multidisciplinary panel of 14 Canadian experts in glioblastoma care was convened, and a comprehensive literature review was conducted to synthesize evidence and formulate initial recommendations. Consensus was achieved through three Delphi rounds, in which panelists rated their agreement with recommendation statements on a five-point Likert scale. Statements with ≥75% agreement were accepted, and others were revised for re-voting. Final recommendations were formulated based on the consensus level, strength of evidence, clinical expertise, and consideration of the Canadian healthcare context. These recommendations aim to standardize glioblastoma diagnosis and classification across Canada, provide evidence-based guidance for optimal treatment selection, integrate novel therapies, and enhance the overall quality of care for glioblastoma patients.

摘要

胶质母细胞瘤是成人中最常见且侵袭性最强的恶性脑肿瘤,其发病率呈上升趋势,预后较差。胶质母细胞瘤治疗目前面临的挑战包括肿瘤生长迅速、治疗效果有限、复发率高以及对患者生活质量产生重大影响。鉴于胶质母细胞瘤护理的复杂性以及诊断和治疗方式的最新进展,加拿大需要更新指南。这项德尔菲研究旨在为新诊断和复发性胶质母细胞瘤的诊断、分类和管理制定加拿大共识建议。召集了一个由14名加拿大胶质母细胞瘤护理专家组成的多学科小组,并进行了全面的文献综述,以综合证据并制定初步建议。通过三轮德尔菲法达成共识,小组成员在五点李克特量表上对他们对建议声明的同意程度进行评分。达成≥75% 共识的声明被接受,其他声明则进行修订后重新投票。最终建议是根据共识水平、证据强度、临床专业知识以及对加拿大医疗环境的考虑制定的。这些建议旨在规范加拿大全国范围内的胶质母细胞瘤诊断和分类,为最佳治疗选择提供循证指导,整合新疗法,并提高胶质母细胞瘤患者的整体护理质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d6/12026134/26a6cdf0e93a/curroncol-32-00207-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d6/12026134/b4080c60e9c8/curroncol-32-00207-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d6/12026134/26a6cdf0e93a/curroncol-32-00207-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d6/12026134/b4080c60e9c8/curroncol-32-00207-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2d6/12026134/26a6cdf0e93a/curroncol-32-00207-g002.jpg

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引用本文的文献

[1]
A Positive Feedback DNA-PK/MYT1L-CXCR1-ERK1/2 Proliferative Signaling Loop in Glioblastoma.

Int J Mol Sci. 2025-5-6

本文引用的文献

[1]
Contemporary prognostic signatures and refined risk stratification of gliomas: An analysis of 4400 tumors.

Neuro Oncol. 2025-1-12

[2]
No benefit from TMZ treatment in glioblastoma with truly unmethylated MGMT promoter: Reanalysis of the CE.6 and the pooled Nordic/NOA-08 trials in elderly glioblastoma patients.

Neuro Oncol. 2024-10-3

[3]
Quantitative analysis of promoter methylation in glioblastoma suggests nonlinear prognostic effect.

Neurooncol Adv. 2023-9-19

[4]
Combined Immunotherapy Improves Outcome for Replication-Repair-Deficient (RRD) High-Grade Glioma Failing Anti-PD-1 Monotherapy: A Report from the International RRD Consortium.

Cancer Discov. 2024-2-8

[5]
Are we providing best-available care to newly diagnosed glioblastoma patients? Systematic review of phase III trials in newly diagnosed glioblastoma 2005-2022.

Neurooncol Adv. 2023-9-4

[6]
Reirradiation versus systemic therapy versus combination therapy for recurrent high-grade glioma: a systematic review and meta-analysis of survival and toxicity.

J Neurooncol. 2023-9

[7]
Updated systematic review and meta-analysis of extended adjuvant temozolomide in patients with newly diagnosed glioblastoma.

Neurooncol Adv. 2023-7-13

[8]
Mismatch repair protein mutations in isocitrate dehydrogenase (IDH)-mutant astrocytoma and IDH-wild-type glioblastoma.

Neurooncol Adv. 2023-7-12

[9]
Association of Tumor Treating Fields (TTFields) therapy with survival in newly diagnosed glioblastoma: a systematic review and meta-analysis.

J Neurooncol. 2023-8

[10]
Efficacy and safety of innate and adaptive immunotherapy combined with standard of care in high-grade gliomas: a systematic review and meta-analysis.

Front Immunol. 2023

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