Figura 1. Esquemas de tratamiento de clase I empleados en los gliomas de alto grado. d: día; fr: fracción; PCV: procarbacina, lomustina y vincristina; RDT: radioterapia; TMZ: temozolomida.
Figura 2. Esquemas de tratamiento de clase I empleados en los gliomas de bajo grado. d: día; fr: fracción; PCV: procarbacina, lomustina y vincristina; RDT: radioterapia; TMZ: temozolomida.
Historical perspective of the studies with the greatest impact on the treatment of gliomas
Summary. Historically, advances in our knowledge of neuro-oncology and improvements in the survival of patients with brain tumours have been relatively scarce. One of the main turning points can be established from 2005 onwards, when the potential therapeutic role of cytostatics in these tumours was confirmed, thus changing the standard of treatment. Up until that date, only radiation therapy and surgery were considered truly effective treatments. This shift has contributed to the development of new systemic therapies and to an in-depth study of gliomagenesis. Advances in the knowledge of the basic fields of brain tumours have helped improve the design and results of new clinical trials, while clinical outcomes provide feedback and new data to further the understanding of these tumours. However, these promising advances open up new unresolved questions and offer a critical approach to the interpretation of past studies. This review mainly updates the results of trials that changed or modified the clinical practice of the treatment and management of gliomas. Commenting on relevant basic research papers that have not yet been translated into the implementation of changes in the treatment of these patients is excluded.
Key words. Astrocytoma. Clinical trial. Glioblastoma. Gliomas. Meta-analysis. Neuro-oncology. Oligodendroglioma. Primary brain tumours.