[1]黄传平,刘忆,梁浩欣,等.脑膜瘤多次术后复发并恶变的靶向治疗分析：附1例报道并文献复习[J].中国临床神经外科杂志,2022,27(11):902-904908.[doi:10.13798/j.issn.1009-153X.2022.11.007]
　HUANG Chuan-ping,LIU Yi,LIANG Hao-xin,et al.Analysis of targeted therapy for recurrent meningiomas associated with malignant transformation: report of one case and literature review[J].,2022,27(11):902-904908.[doi:10.13798/j.issn.1009-153X.2022.11.007]
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脑膜瘤多次术后复发并恶变的靶向治疗分析：附1例报道并文献复习()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
27
期数:
2022年11期
页码:
902-904908
栏目:
论著
出版日期:
2022-11-30

文章信息/Info

Title:
Analysis of targeted therapy for recurrent meningiomas associated with malignant transformation: report of one case and literature review
文章编号:
1009-153X（2022）11-0902-03
作者:
黄传平; 刘忆; 梁浩欣; 李刚; 陈纪超; 包赟; 漆松涛
510515 广州，南方医科大学南方医院神经外科（黄传平、刘忆、梁浩欣、李刚、包赟、漆松涛）；510280 广州，南方医科大学第二临床学院（梁浩欣）
Author(s):
HUANG Chuan-ping1;  LIU Yi1;  LIANG Hao-xin1; 2;  LI Gang1;  CHEN Ji-chao1;  BAO Yun1;  Qi Song-tao1
1. Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; 2. The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510280, China
关键词:
脑膜瘤; 术后复发; 恶变; 靶向治疗
Keywords:
Meningioma;  Postoperative recurrence;  Malignant transformation;  Targeted therapy
分类号:
R739.41
DOI:
10.13798/j.issn.1009-153X.2022.11.007
文献标志码:
A
摘要:
目的 探讨脑膜瘤术后复发并恶变的靶向治疗效果。方法 回顾性分析1例鞍区脑膜瘤的临床资料，并结合相关文献进行分析。结果 52岁男性，因鞍区脑膜瘤切除术后13年伴视力进行性下降3年于2020年5月12日入院；2007年首次手术近全切除鞍区肿瘤，术后病理示脑膜瘤（WHO分级Ⅰ级）；2009年复查MRI显示肿瘤明显增大，2009~2018年共行6次伽玛刀治疗；2019年复查MRI显示肿瘤无增大；2020年复查MRI显示肿瘤再次明显增大，再次手术全切除肿瘤，术后病理示不典型脑膜瘤（WHO分级Ⅱ级），6个月后肿瘤再次复发，根据基因检测和类器官培养的药敏结果，选择舒尼替尼进行靶向治疗（37.5 mg，1次/d，持续4周，停药2周）；靶向治疗6个月复查MRI显示肿瘤缩小，但9个月时复查MRI显示肿瘤增大，病人拒绝继续靶向治疗，神志清楚，双目失明，能搀扶行走。结论 脑膜瘤术后复发并恶变时，靶向治疗短期内可缩小肿瘤体积，长期效果有待继续研究。
Abstract:
Objective To investigate the effect of targeted therapy on recurrent meningiomas associted with malignant transformation. Methods The clinical data of 1 patient with sellar meningioma were analyzed retrospectively and the related literatures were reviewed. Results A 52-year-old male was admitted to our hospital due to progressive vision loss for 3 years on May 12, 2020. A sellar tumor was subtotally resected in 2007 and the postoperative pathological results showed meningioma (WHO grade Ⅰ). MRI showed that the tumor was significantly progressed in 2009. Six gamma knife treatments were performed on the patient from 2009 to 2018. MRI showed no tumor progression in 2019. However, MRI showed that the tumor significantly progressed again in 2020, and the tumor was completely removed by re-operation. The postoperative pathological results showed atypical meningioma (WHO grade Ⅱ). The tumor recurred 6 months later. According to the drug sensitivity results of gene testing and organoid culture, Sunitinib was selected for targeted therapy (37.5 mg, once a day for 4 weeks, drug withdrawal for 2 weeks). Six months after targeted therapy, MRI showed significant shrinkage of the tumor. But 9 months after targeted therapy, MRI showed tumor progression. The patient refused to continue targeted therapy. He was blind and was able to walk with support. Conclusions For patients with recurrent meningioma associated with malignant transformation, targeted therapy can reduce the tumor volume in a short time, but the long-term outcomes need to be accumulated experience.

参考文献/References:

[1] Karsy M, Azab MA, Abou-Al-Shaar H, et al. Clinical potential of meningioma genomic insights: a practical review for neurosurgeons [J]. Neurosurg Focus, 2018, 44(6): E10-E17.
[2] Kaley TJ, Wen P, Schiff D, et al. Phase II trial of sunitinib for recurrent and progressive atypical and anaplastic meningioma [J]. Neuro Oncol, 2015, 17(1): 116-121.
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备注/Memo

备注/Memo:
（2022-08-25收稿，2022-10-15修回）
通讯作者：漆松涛，E-mail：qisongtaosjwk@163.com
更新日期/Last Update: 2022-12-31