中国现代神经疾病杂志 ›› 2019, Vol. 19 ›› Issue (11): 826-831. doi: 10.3969/j.issn.1672-6731.2019.11.005

• 专题讲座 • 上一篇    下一篇

2 脑胶质瘤疗效评价进展

易立1, 王旭亚1, 初曙光2, 秦智勇3, 杨学军1   

  1. 1. 300052 天津医科大学总医院神经外科;
    2. 200120 上海, 同济大学附属东方医院医学影像科;
    3. 200040 上海, 复旦大学附属华山医院神经外科
  • 收稿日期:2019-11-16 出版日期:2019-11-25 发布日期:2019-11-25
  • 通讯作者: 杨学军,Email:ydenny@126.com

Ongoing evolution of response assessment in glioma

YI Li1, WANG Xu-ya1, CHU Shu-guang2, QIN Zhi-yong3, YANG Xue-jun1   

  1. 1 Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China;
    2 Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China;
    3 Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
  • Received:2019-11-16 Online:2019-11-25 Published:2019-11-25
  • Contact: YANG Xue-jun (Email: ydenny@126.com)

摘要:

脑胶质瘤的异质性和治疗抵抗性可能在很大程度上解释脑胶质瘤的不良预后,但临床疗效反应评价体系的不完整性是导致患者预期预后与真实预后混淆的根本原因。目前经典的Macdonald标准和神经肿瘤反应评价(RANO)标准已长期用于评价脑胶质瘤的治疗反应,但Macdonald标准仅阐述肿瘤的增强对比成分,不能真实反映肿瘤的生长或活性。为抵御这种恶性肿瘤,有必要继续补充评价体系。本文重点介绍经典的Macdonald标准的不足之处,同时推荐RANO标准及其衍生标准的可行性。

关键词: 神经胶质瘤, 预后, 磁共振成像, 综述

Abstract:

The complex heterogeneity and therapeutic resistance of malignant glioma may largely account for the poor prognosis of glioma. The incomplete response assessment system of clinical outcomes is an underlying cause for the confounding of true prognostic benefits expected in patients with glioma. The investigation and development of recently introduced agents or radiological measurements caused emergent misunderstandings to the response assessment of glioma. To date, the classical Macdonald's criteria and the Response Assessment of Neuro-Oncology (RANO) criteria have been used successively for the evaluation of glioma outcome. However, the Macdonald's criteria only addresses the contrast-enhancement component of the tumor, which is only a surrogate to true tumor growth and activity. Ongoing efforts on complementary assessments are necessary to combat malignant glioma. In this review, we highlight the shortcomings of the current criteria and introduce the initiative effort of RANO criteria and its offspring.

Key words: Glioma, Prognosis, Magnetic resonance imaging, Review