BORON NEUTRON CAPTURE THERAPY FOR MALIGNANT TUMORS RELATED TO MENINGIOMAS
BORON NEUTRON CAPTURE THERAPY FOR MALIGNANT TUMORS RELATED TO MENINGIOMAS
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DOI：
10.1227/01.neu.0000279727.90650.24
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发表时间：
2007-07
期刊：
影响因子：
4.8
通讯作者：
S. Miyatake;Yoji Tamura;S. Kawabata;Kyoko Iida;T. Kuroiwa;K. Ono
中科院分区：
文献类型：
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作者：
S. Miyatake;Yoji Tamura;S. Kawabata;Kyoko Iida;T. Kuroiwa;K. Ono
目的恶性脑膜瘤与胶质母细胞瘤一样，是一种较难控制的肿瘤。我们尝试用硼中子俘获治疗（BNCT）来控制脑膜瘤相关的恶性肿瘤。方法自2005年6月以来，对7例脑膜瘤相关恶性肿瘤患者进行了13轮中子照射的BNCT治疗。3例为间变性脑膜瘤，2例为乳头状脑膜瘤，1例为非典型脑膜瘤，1例为脑膜瘤转化的肉瘤伴颈淋巴结转移。所有患者既往均接受过重复手术和放疗。6名患者的随访图像可用，观察期为7至13个月。我们应用18F-硼苯丙氨酸（BPA）-正电子发射断层扫描（PET）前BNCT在7例患者中的6例。1例患者接受了蛋氨酸-PET而不是18 F-BPA-PET。结果：6名接受BPA-PET分析的患者中有5名显示出良好的BPA摄取，肿瘤与健康大脑的比值大于2.7。非典型脑膜瘤病例显示肿瘤与健康脑的比率为2.0。原始肿瘤大小在13.6和109 ml之间。三例间变性脑膜瘤中有两例显示完全缓解，所有六例可进行随访的患者影像学均显示改善。BNCT前的临床症状，如轻偏瘫和面部疼痛，除1例外，所有患者在BNCT后均得到改善。在这个病人中，一个巨大的非典型脑膜瘤起源于镰幕交界处，并延伸到双侧枕叶和脑干;重复BNCT后视力问题恶化，瘤周水肿增加。结论恶性脑膜瘤是BNCT的良好选择。
OBJECTIVE Malignant meningiomas, similar to glioblastomas, are difficult tumors to control. We tried to control malignant tumors related to meningiomas by boron neutron capture therapy (BNCT). METHODS Since June 2005, we applied BNCT with 13 rounds of neutron irradiation to seven cases of malignant tumors related to meningiomas. Three were anaplastic meningiomas, two were papillary meningiomas, one was an atypical meningioma, and one was a sarcoma transformed from a meningioma with cervical lymph node metastasis. All patients had previously undergone repetitive surgeries and radiotherapy. Follow-up images were available for six patients with an observation period between 7 and 13 months. We applied 18F-boronophenylalanine (BPA)-positron emission tomography (PET) before BNCT in six of the seven patients. One patient underwent methionine-PET instead of 18F-BPA-PET. RESULTS Five of the six patients who underwent BPA-PET analysis showed good BPA uptake, with a greater than 2.7 tumor-to-healthy brain ratio. The atypical meningioma case showed a tumor-to-healthy brain ratio of 2.0. The original tumor sizes were between 13.6 and 109 ml. Two of the three anaplastic meningiomas showed a complete response, and all six patients available for follow-up imaging showed radiographic improvements. Clinical symptoms before BNCT, such as hemiparesis and facial pain, were improved after BNCT in all but one patient. In this patient, a huge atypical meningioma arose from the falcotentorial junction and extended to the bilateral occipital lobes and brainstem; visual problems worsened after repetitive BNCT, with an increase in peritumoral edema. CONCLUSION Malignant meningiomas seem to be good candidates for BNCT.