髄膜腫に対する放射線治療の位置付け

Defining the Role of Radiotherapy in Meningioma Treatment

Point

・髄膜腫の再発リスクに関する層別化が進められ，髄膜腫においても分子診断が重要な役割を果たすようになってきた．

・放射線治療の役割は層別化に応じてより明確になっていくが，髄膜腫における放射線治療の臨床的な位置付けは未だ不明確である．

・放射線照射の標的領域の設定は治療成績を左右し得るが，PET画像などの腫瘍特性を反映した照射計画が試みられている．

・ホウ素中性子捕捉療法は生物学的に細胞レベルで治療ができることから，髄膜腫においても効果が期待されている．

　The debate regarding the role and clinical impact of radiotherapy for meningiomas remains underdeveloped due to insufficient evidence. However, following recent revisions in the WHO classification and the integration of molecular diagnostics, there has been a substantial shift in the stratification of recurrence risks. Nevertheless, the specific circumstances under which radiotherapy proves crucial remain unclear. As risk stratification becomes more refined, the effectiveness of radiotherapy in treating high-risk meningiomas continues to be a contentious issue. Concurrently, there is vigorous discussion regarding the management of ‘brain invasion in otherwise benign'（BIOB）meningiomas. The incorporation of PET imaging alongside MRI for defining radiation targets is increasingly acknowledged as advantageous. Boron neutron capture therapy（BNCT）, which specifically targets the biological characteristics of tumor cells in invasive regions, is also gaining significant traction as a promising therapeutic approach for meningiomas with infiltrative components.