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中华神经创伤外科电子杂志 ›› 2023, Vol. 09 ›› Issue (04) : 193 -198. doi: 10.3877/cma.j.issn.2095-9141.2023.04.001

述评

大脑凸面脑膜瘤的个体化全程管理
钟东()   
  1. 400042 重庆,重庆医科大学附属第一医院神经外科
  • 收稿日期:2023-07-05 出版日期:2023-08-15
  • 通信作者: 钟东

Individualized full process management of cerebral convex meningioma

Dong Zhong()   

  1. Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China
  • Received:2023-07-05 Published:2023-08-15
  • Corresponding author: Dong Zhong
引用本文:

钟东. 大脑凸面脑膜瘤的个体化全程管理[J]. 中华神经创伤外科电子杂志, 2023, 09(04): 193-198.

Dong Zhong. Individualized full process management of cerebral convex meningioma[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2023, 09(04): 193-198.

大脑凸面脑膜瘤是常见的偶发脑肿瘤,约占颅内脑膜瘤的15%~25%。凸面脑膜瘤的最佳治疗方案目前尚存争议,脑膜瘤生物学、影像学研究的最新进展实现了患者的精准个体化临床风险分层,可以指导患者影像学监测、手术治疗及术后放射治疗的决择。个体化管理方法可用来平衡积极地全切肿瘤和保护邻近神经功能结构,同时考虑患者自身身体条件、脑膜瘤的特异性因素(如脑膜瘤生物学特性、具体位置、影像学特征)以及放射治疗的可能性。凸面脑膜瘤的分层管理方法是高度个性化的,需要考虑患者的年龄、预期寿命、目前的神经功能状态、脑膜瘤的自然病史、伴发其他疾病优先级,并涉及围绕治疗目标、肿瘤控制的持久性、不良反应和不同处理措施后患者的生活质量来综合决策。本文主要围绕大脑凸面脑膜瘤的个体化全程管理作一述评。

Cerebroconvex meningioma is a common incidental brain tumor, accounting for approximately 15% to 25% of intracranial meningiomas. The optimal treatment plan for convex meningioma is currently controversial, and the recent advances in the biology and imaging studies of meningiomas allow for precise individualized clinical risk stratification of patients, which can guide decisions regarding imaging monitoring, surgery, and postoperative radiotherapy. An individualized approach can be used in clinical work to balance aggressive total tumor resection and the protection of adjacent neurofunctional structures, while considering the patient's own physical conditions, meningioma-specific factors (e.g., meningioma biology, specific location, and imaging features), and the possibility of radiotherapy. The stratified approach to the management of convexity meningiomas is highly individualized, taking into account the patient's age, life expectancy, current neurological status, natural history of the meningioma, priority of other concomitant diseases, and involves comprehensive decision-making around treatment goals, durability of tumor control, adverse events, and quality of life of the patient after different management measures. This article mainly reviews the personalized full process management of cerebral convex meningioma.

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