胶质瘤不化疗也罢

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化疗在胶质瘤治疗中的地位

1: Semin Radiat Oncol. 2009 Jul;19(3):150-4. Chemotherapy for malignant gliomas.

恶性胶质瘤虽然少见但却是非常致命的肿瘤。主流的治疗方法就是手术+放疗。化疗目前起到一个辅助的作用。不幸的是，在现实中，化疗并没有取得实质性的成功。阻止标准化疗制剂的障碍依然存在，主要是药物转运方面的障碍和肿瘤固有的抗药性。新的制剂如贝伐单抗等抗血管新生的药物可能是最新的方向。对肿瘤生物学更深层次的理解，可能会有助于我们找到更多的靶点，从而消灭或者控制肿瘤。

手术在于降低颅内压，获得诊断，最大程度的减少瘤细胞数目，在胶质瘤的治疗中无可替代！

放疗其实也是个局部治疗，在于把那些残留在周边的瘤细胞再次剿灭一部分，作用肯定是有的。

化疗就是全身治疗，能杀死有限的肿瘤细胞，同时也杀灭了很多血细胞，导致贫血，易感染等。

Kreisl TN. Neuro-Oncology Branch, National Cancer Institute, Bethesda, MD 20892, USA. kreislt@mail.nih.gov Malignant gliomas are rare but lethal tumors in which the mainstays of therapy remain surgery and radiation therapy. Chemotherapy currently plays a primarily adjuvant role in the management of these patients with, unfortunately, little success in the recurrent disease setting. Barriers to efficacy of standard cytotoxic agents are related to drug-delivery challenges and inherent chemoresistance. Newer agents designed as directed antiglioma therapy are being explored with exciting preliminary results. Bevacizumab and other antiangiogenic drugs are likely to play a key role in the treatment of malignant glioma, as are combinations of molecularly targeted compounds. A greater understanding of cancer biology has afforded an increasing number and variety of oncogenic targets for therapeutic development, providing hope for brain tumor patients with historically poor outcomes.