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脑膜瘤的医学管理。

Medical management of meningiomas.

作者信息

Chukwueke Ugonma N, Wen Patrick Y

机构信息

Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Division of Neuro-Oncology, Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States.

Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, United States; Division of Neuro-Oncology, Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States.

出版信息

Handb Clin Neurol. 2020;170:291-302. doi: 10.1016/B978-0-12-822198-3.00048-3.

Abstract

Meningiomas are the most frequently occurring primary brain tumors in adults, representing almost one-third of all primary central nervous system tumors. Several factors have been suggested as an underlying cause in the development of meningiomas, such as ionizing radiation (therapeutic or other incidental exposure), hormonal factors, and genetic predisposition syndromes. Other established factors associated with meningiomas include age, female gender, and those from non-Hispanic Black backgrounds. Though the 2016 World Health Organization Classification of Brain Tumors largely preserves the existing grading scheme for organization of meningioma, there is increasing understanding of the molecular factors underlying the development of meningioma, some of which now form the basis for active clinical investigation. The mainstay of treatment has been the combination of radiation therapy and surgery, with a limited role for systemic therapy due to low efficacy, short duration of treatment response, and lack of uniform response criteria. Similar to other primary and metastatic brain tumors, immune-based therapies hold promise and are still under investigation.

摘要

脑膜瘤是成人中最常见的原发性脑肿瘤,占所有原发性中枢神经系统肿瘤的近三分之一。有几个因素被认为是脑膜瘤发生的潜在原因,如电离辐射(治疗性或其他意外暴露)、激素因素和遗传易感性综合征。与脑膜瘤相关的其他既定因素包括年龄、女性性别以及非西班牙裔黑人背景。尽管2016年世界卫生组织脑肿瘤分类在很大程度上保留了现有的脑膜瘤组织分级方案,但人们对脑膜瘤发生的分子因素的认识越来越多,其中一些因素现在构成了积极临床研究的基础。治疗的主要方法一直是放射治疗和手术相结合,由于疗效低、治疗反应持续时间短以及缺乏统一的反应标准,全身治疗的作用有限。与其他原发性和转移性脑肿瘤一样,基于免疫的疗法有前景且仍在研究中。

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