Neurological Surgery 脳神経外科35巻1号

2007年01月発行

総説

転移性脳腫瘍に対する放射線治療

著者： 中洲庸子¹

所属機関： ¹県立静岡がんセンター脳神経外科

ページ範囲：P.7 - P.16

緒言

　転移性脳腫瘍に対する診断／治療が着実に進歩して，過去30年間に，患者の生活の質（QOL）の改善と生存期間の延長に貢献してきた．転移性脳腫瘍の患者の余命は，ステロイド剤投与のみでは，わずか1～2カ月であったが，全脳照射で4～5カ月までに，さらに手術または定位放射線照射（stereotactic irradiation，SRI）^注1)と全脳照射の組み合わせで，中央値が6～12カ月と延長した²⁰⁾．これで，脳転移を来したがん患者の生命予後を決定するのは，中枢神経系ではなく，多くは全身臓器の病態であると，いったん考えられるようになった．

　ところが，最近，特に化学療法のめざましい進歩を中心として，各臓器のがん治療の成績が向上しており，そのために中枢神経系への転移の問題が患者のQOLと生存期間を制限する因子として，再び重要となってきた．この揺り戻しは，年々顕著となりつつあり，転移性脳腫瘍の治療は新しい進展を求められ，多くの課題を投げ返されたかたちになっている．

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