对脑肿瘤的声动力疗法的评论

声动力疗法（SDT）正在作为一种有希望的新的非侵入性脑肿瘤治疗，其靶向并选择性地杀死肿瘤细胞，副作用有限。这篇综述研究了SDT和正在进行的临床试验的机制，以优化超声处理参数，以治疗胶质母细胞瘤（GBM）（GBM）和弥漫性内在蓬托神经胶质瘤（DIPG）。简要讨论了在梅奥诊所接受过重复GBM的第一位患者的结果。该文献综述的作者使用了包括PubMed，Embase和Ovid在内的电子数据库。通过搜索文本单词/短语和网状术语，包括以下内容：“超声动力疗法”，“ SDT”，“聚焦超声”，“ 5-ala”，“ Ala”，“ Ala”，“ ala tumors”，“ difuse pontine gliomoma，“ gliomama clun inlialing and glimaning and gli andy gli and gli and gli and gli gli gli gli gli gli gli gli gli gli）综述了在脑肿瘤中使用SDT。在高级神经胶质瘤和GBM的临床前模型中，SDT通过产生活性氧，显示了靶向肿瘤细胞死亡的证据。复发性GBM和DIPG中的新兴临床试验结果显示出成功治疗反应的证据，招募患者经历的副作用最少。到目前为止，SDT已被证明是一种有希望的非侵入性癌症治疗，患者耐受性良好。作者提出了试点数据，表明GBM对单个SDT治疗的良好放射学反应，即使经过多次（每月）超声门诊治疗，也未发表的观察到缺乏脱靶效应。 SDT的临床试验范围是研究是否可以将GBM或DIPG致命诊断转化为慢性，可治疗疾病的手段。SDT安全，可重复性且比化学疗法和放射疗法更具耐受性。已显示它在人类癌症治疗中有效，但是需要更多的临床试验来建立用于递送Sonosensitizer，治疗参数和组合疗法的标准化方案。最合适的治疗时间还尚待确定，以防止术后复发，还是作为复发性GBM患者的打捞选择，重做手术是不合适的。希望也将开发SDT，以用于更广泛的临床适应症，例如转移，脑膜瘤和低度胶质瘤。进一步的临床试验正在准备。

Sonodynamic therapy (SDT) is gaining attention as a promising new noninvasive brain tumor treatment that targets and selectively kills tumor cells, with limited side effects. This review examines the mechanisms of SDT and ongoing clinical trials looking at optimization of sonication parameters for potential treatment of glioblastoma (GBM) and diffuse intrinsic pontine glioma (DIPG). The results in the first patient with recurrent GBM treated at the Mayo Clinic are briefly discussed.The authors of this literature review used electronic databases including PubMed, EMBASE, and OVID. Articles reporting relevant preclinical and clinical trials were identified by searching for text words/phrases and MeSH terms, including the following: "sonodynamic therapy," "SDT," "focused ultrasound," "5-ALA," "ALA," "brain tumors," "diffuse pontine glioma," "glioblastoma," and "high grade glioma."Preclinical and clinical trials investigating the specific use of SDT in brain tumors were reviewed. In preclinical models of high-grade glioma and GBM, SDT has shown evidence of targeted tumor cell death via the production of reactive oxygen species. Emerging clinical trial results within recurrent GBM and DIPG show evidence of successful treatment response, with minimal side effects experienced by recruited patients. So far, SDT has been shown to be a promising noninvasive cancer treatment that is well tolerated by patients. The authors present pilot data suggesting good radiological response of GBM to a single SDT treatment, with unpublished observation of a lack of off-target effects even after multiple (monthly) sonication outpatient treatments. The scope of the clinical trials of SDT is to investigate whether it can be the means by which the fatal diagnosis of GBM or DIPG is converted into that of a chronic, treatable disease.SDT is safe, repeatable, and better tolerated than both chemotherapy and radiotherapy. It has been shown to have an effect in human cancer therapy, but more clinical trials are needed to establish standardized protocols for sonosensitizer delivery, treatment parameters, and combination therapies. The most appropriate timing of treatment also remains to be determined-whether to prevent recurrence in the postoperative period, or as a salvage option in patients with recurrent GBM for which redo surgery is inappropriate. It is hoped that SDT will also be developed for a wider spectrum of clinical indications, such as metastases, meningioma, and low-grade glioma. Further clinical trials are in preparation.