Chemoradiotherapy in malignant glioma: standard of care and future directions.

摘要: Glioma has been considered resistant to chemotherapy and radiation. Recently, concomitant adjuvant chemoradiotherapy with temozolomide become the standard treatment for newly diagnosed glioblastoma. Conversely (neo-)adjuvant PCV (procarbazine, lomustine, vincristine) failed improve survival in more chemoresponsive tumor entities of anaplastic oligoastrocytoma oligodendroglioma. Preclinical investigations suggest synergism or additivity radiotherapy glioma cell lines. Although relative contribution chemotherapy, respectively, cannot be assessed, early introduction simultaneous administration appear key improvement outcome. Epigenetic inactivation DNA repair enzyme methylguanine methyltransferase (MGMT) seems strongest predictive marker outcome patients treated alkylating agent chemotherapy. Patients whose tumors do not have MGMT promot...