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黑色素瘤脑转移治疗模式的发展:对当前模式的系统性审查

Krista-Gaie Grant¹, Yasmine Gillespie¹, Armin Karamian²

¹University of Florida, College of Medicine, Gainesville, FL, United States.

Clinical neurology and neurosurgery

|July 3, 2025

概括

黑色素瘤脑转移 (MBM) 的治疗正在向多式模式策略发展. 免疫检查点抑制剂 (ICI) 与立体射线手术 (SRS) 结合,有望改善MBM患者的存活率和内控制.

科学领域:

在瘤学瘤学.
神经学神经学
医学研究医学研究

背景情况:

黑色素瘤大脑转移 (MBM) 在晚期黑色素瘤中构成重大挑战,导致预后不佳和神经学缺陷.
新兴治疗方法的最佳整合,如免疫检查点抑制剂 (ICI),向疗法和MBM的立体射线外科手术 (SRS) 仍然不清楚.

研究的目的:

系统地审查和综合有关黑色素瘤脑转移当前治疗方法的证据.
评估全身疗法,放射治疗,手术和MBM的组合疗法的疗效和安全性.

主要方法:

2009年至2024年间在PubMed,Scopus和Web of Science发表的研究的系统综述.
包括报告总生存 (OS),无进展生存 (PFS),内反应率 (IRR) 和不良事件 (AE) 的研究.
使用既有工具进行偏差风险评估 (科克兰,纽卡斯尔-太华,JBI).

主要成果:

免疫检查点抑制剂 (ICI) 显示出持久的反应,特别是在无症状患者中.
向疗法提供了快速的内控制,而SRS改善了局部控制,具有低毒性和与ICI的协同效应.
三重模式策略 (手术+SRS+全身疗法) 在选定的患者中显示出最有前途的生存结果,平均寿命从5.3到15.9个月不等.

结论:

MBM的管理正在越来越多地采用多式联络方法,整合本地和系统疗法.
免疫检查点抑制剂 (ICI) 与立体射线手术 (SRS) 结合,是当前治疗范式的核心.
进一步的前性,生物标志物驱动的研究对于优化治疗序列,最大限度地提高内控制和提高患者生活质量 (QoL) 是必不可少的.

关键词:

BRAF/MEK 抑制剂的使用组合疗法是一种联合疗法.免疫检查点抑制剂免疫检查点抑制剂内疾病控制内疾病控制黑色素瘤发生大脑转移.多种模式的治疗方法.总体生存率总体生存率没有进展的生存率.立体无线电外科手术立体无线电外科手术系统性疗法是一种全身疗法.

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