| 陶浩军,曾 强,王天翔,等.胶质母细胞瘤复发进展的分子机制与多维治疗策略[J].肿瘤学杂志,2026,32(7):589-600. |
| 胶质母细胞瘤复发进展的分子机制与多维治疗策略 |
| Recurrent Mechanisms of Glioblastoma and Its Multidimensional Treatment Strategies |
| 投稿时间：2026-02-04 |
| DOI：10.11735/j.issn.1671-170X.2026.07.B010 |
|
 |
| 中文关键词: 胶质母细胞瘤 复发 治疗 再程放疗 外科手术 |
| 英文关键词:glioblastoma recurrence treatment re-irradiation surgery |
| 基金项目:2024年度高水平医院建设“移山计划”培育项目（YSPY202407） |
|
| 摘要点击次数: 6 |
| 全文下载次数: 0 |
| 中文摘要: |
| 摘 要：复发性胶质母细胞瘤（recurrent glioblastoma，rGBM）具有高发生率、高死亡率的特点，复发后的治疗方案选择尤为重要，临床医师应根据患者的临床状态、肿瘤特征、肿瘤分子/病例特性，考虑多维治疗策略。全文综述了rGBM复发的核心机制、治疗策略，探讨了该领域的关键挑战。再次手术仍是治疗rGBM的首选方案，可显著延长患者的总生存期，尤其适用于局灶性复发、体能状态良好的患者，但无法清除浸润边缘的肿瘤细胞。再程放疗特别适用于不适合再次手术或术后残留的患者。洛莫司汀、替莫唑胺及瑞戈非尼是挽救性化疗的常用方案。贝伐珠单抗虽不能延长患者的总生存期，但可以改善无进展生存期和生活质量。在创新局部物理治疗方面，肿瘤电场治疗通过交变电场干扰有丝分裂，可与放化疗协同使用；激光间质热疗不仅消融肿瘤，还能诱导抗肿瘤免疫；聚焦超声可暂时、可逆开放血脑屏障，将化疗药物浓度提升数倍，并具有免疫调节作用。免疫治疗通过新辅助给药、联合放疗或局部递送显现希望。未来，临床医师应根据患者的基因、肿瘤分子表型、免疫状态等因素，定制个性化的治疗方案和针对不同rGBM亚型开发和应用药物，为rGBM患者找到新出路。 |
| 英文摘要: |
| Abstract： Recurrent glioblastoma (rGBM) is characterized by a high incidence and high mortality. The choice of treatment after recurrence is particularly important. Multidimensional treatment strategies should be considered based on patients’ clinical status， characteristics， and tumor molecular/case features by clinicians. This paper reviews the core molecular mechanisms and treatment strategies of rGBM recurrence， and discusses the key challenges in this field. Repeat surgery remains the first-line treatment for rGBM and can significantly prolong overall survival， especially for patients with localized recurrence and good physical condition， but it cannot eliminate tumor cells at the infiltrative margins. Re-irradiation is particularly suitable for patients who are not suitable for repeat surgery or have residual tumors after surgery. Iomustine， temozolomide and regorafenib are commonly used options of salvage chemotherapy. Although bevacizumab does not extend overall survival， it improves progression-free survival and quality of life. In innovative local physical therapies， tumor treating fields interfere with mitosis through alternating electric fields and can synergize with radiotherapy and chemotherapy； laser interstitial thermal therapy not only ablates tumors but also induces anti-tumor immunity； focused ultrasound can open the blood-brain barrier temporarily and reversibly， increase the concentration of chemotherapy drugs several-fold and exert immune-modulating effects. Immunotherapy shows a promising future through neoadjuvant administration， combination with radiotherapy and local delivery. In the future， personalized plans based on the patients’ genes， tumor molecular phenotypes， immune status， and other factors， along with the development and application of drugs tailored to different rGBM subtypes， will provide new avenues for rGBM patients. |
|
在线阅读
查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|