脳腫瘍に対する再照射

Reirradiation for brain tumor

放射線治療技術や全身治療の進歩に伴い，照射野内再発に対して再照射を検討する機会は増加し，再照射は局所制御や症状緩和を目的とした治療選択肢の1つとなりつつある。転移性脳腫瘍に対する再照射についても近年重要性が増しているが，本稿では主として原発性脳腫瘍に焦点を当てて概説するとともに，実際に当院で再照射を実施した症例を紹介する。

Reirradiation has become an increasingly important treatment option for recurrent brain tumors owing to advances in radiotherapy techniques and systemic therapies. Appropriate patient selection, accurate differentiation between tumor recurrence and treatment-related changes, and careful treatment planning are essential for safe and effective reirradiation. This article summarizes current evidence regarding reirradiation for adult malignant gliomas and pediatric brain tumors, with a particular focus on patient selection, target delineation, dose-fractionation, and recent clinical trials. We also present a representative case from our institution to illustrate practical treatment strategies. Further prospective studies are warranted to establish optimal reirradiation protocols and improve clinical outcomes.