脑膜瘤放疗--现状与前景?

IF 6.4 1区 医学 Q1 ONCOLOGY
Felix Ehret, Leon El Baya, Sara C Erridge, Marc Bussière, Joost J C Verhoeff, Maximilian Niyazi, Matthias Preusser, Giuseppe Minniti, Helen A Shih
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引用次数: 0

摘要

放射治疗,包括传统的分次体外放射治疗、立体定向放射手术和分次立体定向放射治疗,是脑膜瘤跨学科治疗的基石。放射肿瘤学以及神经病理学和影像学等其他领域的最新进展对脑膜瘤放射治疗产生了各种影响。本综述旨在总结脑膜瘤放射治疗的当前和预期进展,以及与之相关的活跃临床试验。在影像学方面,正电子发射断层扫描已被证明对评估脑膜瘤的空间扩展具有重要价值,并可加强靶点划分、治疗反应监测和放疗后的复发评估。包括质子和碳离子在内的粒子疗法以及立体定向放射手术和放射治疗,可以对选定的高级别脑膜瘤患者进行适形治疗,允许剂量升级。此外,新出现的综合分子和基因分类提供了更优越的风险分层,可完善放疗患者的选择。然而,目前直接研究或改进放射治疗的脑膜瘤试验还很少。总之,功能成像、分子和基因诊断以及放射治疗技术的重大进展有可能改善患者的预后,避免过度治疗或治疗不当。合作努力和进一步的临床试验对于优化脑膜瘤放疗至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Radiation Therapy for Meningiomas - Where Do We Stand and What's on the Horizon?

Radiation therapy, including conventionally fractionated external beam radiation therapy, stereotactic radiosurgery, and fractionated stereotactic radiation therapy, is a cornerstone in the interdisciplinary management of meningiomas. Recent advances in radiation oncology and also in other fields, such as neuropathology and imaging, have various implications for meningioma radiation therapy. This review aims to summarize current and anticipated developments, as well as active clinical trials related to the use of radiation therapy for meningiomas. In imaging, positron emission tomography has proven valuable for assessing the spatial extension of meningiomas and may enhance target delineation, treatment response monitoring, and recurrence assessment after radiation therapy. Particle therapy, including protons and carbon ions, as well as stereotactic radiosurgery and fractionated stereotactic radiation therapy, allow for conformal treatments that permit dose escalation in selected patients with high-grade meningiomas. Additionally, emerging integrated molecular and genetic classifications offer superior risk stratification and may refine patient selection for radiation therapy. However, there is a paucity of active meningioma trials directly investigating or refining the use of radiation therapy. In summary, significant advances in functional imaging, molecular and genetic diagnostics, and radiation treatment techniques hold the potential to improve patient outcomes and to avoid over- and undertreatment. Collaborative efforts and further clinical trials are essential to optimize meningioma radiation therapy.

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来源期刊
CiteScore
11.00
自引率
7.10%
发文量
2538
审稿时长
6.6 weeks
期刊介绍: International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field. This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.
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