China Anti-Cancer Association guidelines for integrative diagnosis and treatment of glioma (abridged version)
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摘要: 脑胶质瘤（glioma）是成人最常见的原发性颅内肿瘤，具有高致残率、高复发率等特征，严重影响患者生存质量，威胁患者生命，给患者个人、家庭乃至社会带来沉重负担。当前脑胶质瘤的分型越来越清晰，传统诊疗方案及新型诊疗方案也逐渐精确化、标准化。针对中国人群，该指南结合国内长期以来的脑胶质瘤研究成果和国际最新进展，整合了传统诊疗与新型精准诊疗策略，形成适合中国医生、针对中国人群的脑胶质瘤临床诊疗指南，使国内相关从业人员能够与时俱进，提升中国脑胶质瘤综合诊疗水平，更好地服务于脑胶质瘤患者。Abstract: Glioma is the most common primary intracranial tumor in adults characterized by high morbidity and recurrence rates. It has a serious impact on the quality of life of patients, threatening their lives and presenting a heavy burden to patients, their families, and the society. Currently, the classification of gliomas is becoming clearer, and the traditional and advanced diagnosis and treatment strategies for glioma are gradually becoming more precise and standardized. For the Chinese population, the guideline combines the long-term study results of glioma in Chinese Mainland and latest international progresses, integrating traditional strategies with new precision diagnosis and treatment strategies and forming an integrative clinical diagnosis and treatment guideline suitable for Chinese doctors and patients with glioma. It will enable relevant domestic practitioners to maintain with the times, improve the integrative diagnosis and treatment of glioma in the country, and eventually provide better service for Chinese patients with glioma.
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Key words:
- glioma /
- integrative and holistic medicine /
- Chinese population
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表 1 2021年《WHO中枢神经系统肿瘤分类标准》（第五版）
项目 标准 成人型弥漫性胶质瘤 星形细胞瘤，IDH突变型 少突胶质细胞瘤，IDH突变伴1p/19q联合
缺失型胶质母细胞，IDH野生型 儿童型弥漫性低级别胶质瘤 弥漫性星形细胞瘤，MYB或MYBL1变异型 血管中心型胶质瘤 青少年多形性低级别神经上皮肿瘤 弥漫性低级别胶质瘤，MAPK信号通路
变异型儿童型弥漫性高级别胶质瘤 弥漫性中线胶质瘤，H3 K27变异型 弥漫性大脑半球胶质瘤，H3 G34突变型 弥漫性儿童型高级别胶质瘤，H3野生和IDH野生型 婴儿型半球胶质瘤 局限性星形细胞
胶质瘤毛细胞型星形细胞瘤 有毛细胞样特征的高级别星形细胞瘤 多形性黄色星形细胞瘤 室管膜下巨细胞星形细胞瘤 脊索样胶质瘤 星形母细胞瘤，伴MN1改变 室管膜肿瘤 幕上室管膜瘤 幕上室管膜瘤，ZFTA融合阳性型 幕上室管膜瘤，YAP1融合阳性型 后颅窝室管膜瘤 后颅窝室管膜瘤，PFA组 后颅窝室管膜瘤，PFB组 脊髓室管膜瘤 脊髓室管膜瘤，MYCN扩增型 黏液乳头型室管膜瘤 室管膜下瘤 
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表 2 神经肿瘤临床疗效评价方法（RANO标准）
标准 完全缓解（CR） 部分缓解（PR） 疾病稳定（SD） 疾病进展（PD） T1增强 无 缩小≥50% 变化在−50%至+25% 增加≥25% T2/FLAIR 稳定或减小 稳定或减小 稳定或减小 增加 新发病变 无 无 无 有 激素使用 无 稳定或减少 稳定或减少 不适用* 临床症状 稳定或改善 稳定或改善 稳定或改善 恶化 需要满足条件 以上全部 以上全部 以上全部 任意一项 *：在出现持续的临床症状恶化时，即为疾病进展，但不能单纯的将激素用量增加作为疾病进展的依据
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