[评论] 非典型脑膜瘤的辅助放疗
摘要
手术切除仍是非典型脑膜瘤（对应WHO 2级肿瘤）的主要治疗手段，尤其是在次全切除后复发风险显著的情况下。因此，辅助放疗已被提议作为降低复发风险的一种手段，且其在存在残留肿瘤的患者中的作用相对已被广泛接受。然而，在大体全切除（定义为Simpson分级I–III级）后，其合理性尚不明确：仅行大体全切除的5年无进展生存率为67%–86%，辅助放疗的作用仍存在争议，其疾病控制获益需与潜在毒性相权衡。
English
Surgical resection remains the mainstay of treatment for atypical meningiomas, corresponding to WHO grade 2 tumours, particularly given the substantial risk of recurrence after subtotal resection. Accordingly, adjuvant radiotherapy has been proposed as a means of reducing the risk of recurrence, and its role is relatively well accepted in patients with residual tumour. After gross total resection (defined as Simpson grade I–III), however, the rationale is less clear: 5-year progression-free survival with gross total resection alone is 67–86%, and the role of adjuvant radiotherapy remains controversial, with its benefit in disease control weighed against potential toxicities.