Mansouri Alireza, Guha Daipayan, Klironomos George, Larjani Soroush, Zadeh Gelareh, Kondziolka Douglas
*Division of Neurosurgery, University of Toronto, Toronto, Canada; ‡Department of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto Canada; §Departments of Neurosurgery and Radiation Oncology, NYU Langone Medical Center, New York University.
Neurosurgery. 2015 Apr;76(4):362-71. doi: 10.1227/NEU.0000000000000633.
Meningiomas are among the most common adult brain tumors. Although the optimal management of meningiomas would provide complete elimination of the lesion, this cannot always be accomplished safely through resection. Therefore, other therapeutic modalities, such as stereotactic radiosurgery (as primary or adjunctive therapy), have emerged. In the current review, we have provided an overview of the historical outcomes of various radiosurgical modalities applied in the management of meningiomas. Furthermore, we provide a discussion on key factors (eg World Health Organization grade, lesion size, and lesion location) that affect tumor control and adverse event rates. We discuss recent changes in our understanding of meningiomas, based on molecular and genetic markers, and how these will change our perspective on the management of meningiomas. We conclude by outlining the areas in which knowledge gaps persist and provide suggestions as to how these can be addressed.
脑膜瘤是最常见的成人脑肿瘤之一。尽管脑膜瘤的最佳治疗方法是完全消除病变,但通过手术切除并不总是能安全地实现这一点。因此,其他治疗方式,如立体定向放射外科手术(作为主要或辅助治疗)应运而生。在当前的综述中,我们概述了各种放射外科手术方式应用于脑膜瘤治疗的历史结果。此外,我们讨论了影响肿瘤控制和不良事件发生率的关键因素(如世界卫生组织分级、病变大小和病变位置)。我们基于分子和遗传标记讨论了我们对脑膜瘤认识的最新变化,以及这些变化将如何改变我们对脑膜瘤治疗的看法。我们通过概述仍然存在知识空白的领域并就如何解决这些问题提出建议来得出结论。