Fine H A
Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, Ma.
J Neurooncol. 1994;20(2):111-20. doi: 10.1007/BF01052722.
Although primary brain tumors represent an important cause of cancer related mortality in the United States, advances in the treatment of these tumors has been slow and has generally lagged behind that of most systemic tumors. One of the major reasons for this is the paucity of well conducted, prospective radiation and chemotherapy trials. For the brain tumor trials that have been conducted, small patient numbers, heterogeneous patient populations, and non-uniformity of response criteria, have made the current clinical data base difficult to interpret. Data from several prospective, multi-institutional randomized trials have defined a role for radiation therapy in the treatment of malignant gliomas and on-going trials will help define refinements in technique. Although there does appear to be a place for the use of chemotherapy in the treatment of a subgroup of patients with malignant gliomas, its role for the majority of patients remains unclear. Only through better understanding of the biology of these tumors, more effective therapies, and the implementation of better clinical trial design can we hope to make significant progress in the treatment of malignant gliomas.
尽管原发性脑肿瘤是美国癌症相关死亡的一个重要原因，但这些肿瘤的治疗进展缓慢，总体上落后于大多数全身性肿瘤。造成这种情况的一个主要原因是缺乏精心设计的前瞻性放疗和化疗试验。对于已经开展的脑肿瘤试验，患者数量少、患者群体异质性以及反应标准不统一，使得目前的临床数据库难以解读。来自几项前瞻性、多机构随机试验的数据确定了放射治疗在恶性胶质瘤治疗中的作用，正在进行的试验将有助于确定技术改进。虽然化疗在治疗一部分恶性胶质瘤患者中似乎有一席之地，但其对大多数患者的作用仍不明确。只有通过更好地了解这些肿瘤的生物学特性、采用更有效的治疗方法以及实施更好的临床试验设计，我们才有希望在恶性胶质瘤的治疗上取得重大进展。
