Invasive and non-invasive tumor-treating electric field (TTF) therapy: An exciting advance in oncologic neuromodulation.

IF 8.4 1区医学 Q1 CLINICAL NEUROLOGY

Brain Stimulation Pub Date : 2025-09-01 Epub Date: 2025-07-28 DOI:10.1016/j.brs.2025.07.018

Thomas Eckert, Rishishankar Suresh, M S Zobaer, Nathan C Rowland

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引用次数: 0

Abstract

Background: Tumor-treating fields (TTF) have been shown to slow glioblastoma (GBM) cell growth through mitotic arrest, increased membrane and blood-brain barrier permeability, and other cellular mechanisms. TTF as currently used prolongs GBM survival by 5 months, but there are areas of possible improvement. One of the interesting problems is optimization of TTF delivery to tumor cells, which is attenuated by intervening anatomy and shunting. Current research involving invasive approaches including cranial remodeling, intracortical TTF and intratumoral modulation therapy (IMT) may improve outcomes.

Objective: Present the history of TTF and discuss current areas of research with a focus on invasive TTF.

Methods: We obtained and analyzed studies referencing TTF, invasive TTF, and any of transcranial electrical stimulation (tES), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), vagus nerve stimulation (VNS), peripheral nervous system (PNS), focused ultrasound (FUS), and transcranial magnetic stimulation (TMS) with respect to mechanism of action or anti-cancer-related effects.

Results: Invasive strategies including cranial remodeling and IMT, through stereotaxis like DBS, would help alleviate the current limitations of TTF. In addition, FUS and VNS induce similar blood brain barrier effects and immune modulation as TTF that may enhance and promote an insurmountable host immune response against the immunosuppressive tumor microenvironment.

Conclusions: TTF as currently practiced is a remarkable advance in cancer treatment. Improvements which exploit the effects of TTF in combination with other neuromodulatory modalities or in immunotherapy promise to improve this even further.

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有创和无创肿瘤治疗电场（TTF）疗法：肿瘤神经调节的一个令人兴奋的进展。

背景：肿瘤治疗野（TTF）已被证明通过有丝分裂阻滞、增加膜和血脑屏障通透性以及其他细胞机制来减缓胶质母细胞瘤（GBM）细胞的生长。目前使用的TTF可将GBM的生存期延长5个月，但仍有可能改善的领域。其中一个有趣的问题是优化TTF向肿瘤细胞的递送，通过介入解剖和分流来减弱。目前的研究包括颅骨重塑、皮质内TTF和肿瘤内调节治疗（IMT）等侵入性方法可能会改善预后。目的：介绍TTF的历史，并讨论目前对侵袭性TTF的研究领域。方法：我们收集并分析了TTF、侵袭性TTF以及经颅电刺激（tES）、经颅直流刺激（tDCS）、深部脑刺激（DBS）、迷走神经刺激（VNS）、周围神经系统（PNS）、聚焦超声（FUS）和经颅磁刺激（TMS）的作用机制或抗癌相关作用。结果：包括颅骨重塑和IMT在内的侵入性策略，通过像DBS这样的立体定向，将有助于缓解目前TTF的局限性。此外，FUS和VNS诱导类似于TTF的血脑屏障效应和免疫调节，可以增强和促进宿主对免疫抑制肿瘤微环境的不可克服的免疫反应。结论：TTF目前在癌症治疗中是一个显著的进步。利用TTF与其他神经调节方式或免疫疗法联合作用的改进有望进一步改善这一点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain Stimulation 医学-临床神经学

CiteScore

13.10

自引率

9.10%

发文量

256

审稿时长

72 days

期刊介绍： Brain Stimulation publishes on the entire field of brain stimulation, including noninvasive and invasive techniques and technologies that alter brain function through the use of electrical, magnetic, radiowave, or focally targeted pharmacologic stimulation. Brain Stimulation aims to be the premier journal for publication of original research in the field of neuromodulation. The journal includes: a) Original articles; b) Short Communications; c) Invited and original reviews; d) Technology and methodological perspectives (reviews of new devices, description of new methods, etc.); and e) Letters to the Editor. Special issues of the journal will be considered based on scientific merit.