小児脳腫瘍における腫瘍治療電場（TTF）治療

Tumor-Treating Fields Therapy for Pediatric Brain Tumors

Point

・小児の腫瘍治療電場（TTF）治療の使用実績は限定的だが，報告されている有害事象は成人と同程度である．

・TTF治療の小児高悪性度神経膠腫に対する保険適用を目指した臨床試験が本邦で実施された．

　Tumor-treating fields (TTF) are alternating electric fields applied to the brain through scalp arrays. Although TTF therapy has shown efficacy in adults with supratentorial high-grade glioma, its safety and efficacy in children remain unproven. Pediatric and adult high-grade gliomas differ genetically, but share clinical features that support trials in children. Recently, a pediatric case series using TTF has been reported, and a few prospective studies are underway. Because pediatric high-grade gliomas are rare and genetically diverse, these studies were designed as feasibility trials for various malignant brain tumors. Their primary goal is to confirm safety and feasibility; however, assessing the efficacy in each pediatric tumor subtype, including high-grade gliomas, is challenging. To address this issue, our clinical research team planned an investigator-initiated trial, specifically for pediatric supratentorial high-grade gliomas. The aim of this study was to expand the regulatory approval of TTF therapy in children by establishing safety and exploratory efficacy data supplemented by accumulated evidence in adults.