放疗在高级别脑膜瘤治疗中的作用。

The Role of Radiotherapy in the Treatment of Higher-Grade Meningioma.

机构信息

Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Radiation Oncology, Massachusetts General Hospital, 30 Fruit Street, Boston, MA 02114, USA.

出版信息

Neurosurg Clin N Am. 2023 Jul;34(3):463-478. doi: 10.1016/j.nec.2023.02.013. Epub 2023 Mar 27.

DOI:10.1016/j.nec.2023.02.013

PMID:37210135

Abstract

High-grade meningiomas (atypical and anaplastic/malignant) are at increased risk of recurrence following primary treatment with maximum safe surgical resection. Evidence based on several retrospective and prospective observational studies suggests an important role of radiation therapy (RT) in both adjuvant and salvage settings. At present, adjuvant RT is recommended for incompletely resected atypical meningiomas and anaplastic meningiomas irrespective of resection extent with disease control benefit. In completely resected atypical meningiomas, the role of adjuvant RT remains debatable but should be considered given the aggressive and resistant nature of recurrent disease. Randomized trials are currently underway and may guide optimal postoperative management.

摘要

高级别脑膜瘤（非典型和间变性/恶性）在接受最大限度安全手术切除的初次治疗后复发风险增加。基于几项回顾性和前瞻性观察研究的证据表明，放射治疗（RT）在辅助和挽救治疗中都具有重要作用。目前，辅助 RT 推荐用于不完全切除的非典型脑膜瘤和间变性脑膜瘤，无论切除范围如何，都可获益于疾病控制。在完全切除的非典型脑膜瘤中，辅助 RT 的作用仍存在争议，但鉴于复发性疾病的侵袭性和耐药性，应考虑使用。目前正在进行随机试验，可能会指导最佳的术后管理。