Neurological Surgery 脳神経外科44巻5号

2016年05月発行

連載 脳腫瘍Update

（7）髄膜腫Update—分子病態から薬物療法へ

著者： 川原信隆¹

所属機関： ¹横浜市立大学大学院医学研究科脳神経外科学

ページ範囲：P.415 - P.430

Ⅰ．はじめに
　髄膜腫の診断・治療は，過去20年の間に大きく進歩してきた．その多くはMRIの活用による正確な画像診断，頭蓋底外科の発展による安全確実な外科的切除率の向上，および定位放射線治療の出現による非手術的治療の確立などによるところが大きい．これらの領域では，数多くのreviewや論文が発表されている．その一方で，これらの治療に抵抗性で，WHO grade Ⅰでも再発を繰り返す例やgrade Ⅱ，Ⅲの予後不良の症例が存在することも事実である．このような症例は比較的稀なためあまり注目されてこなかったが，最近のgenome研究の進展により過去数年間で研究が大きく進歩し，神経膠腫では分子診断が導入される時代となりつつあり，髄膜腫の領域においても確実にその分子病態の理解が進んでいる．本稿では，これらの領域に注目して文献をreviewし，治療抵抗性髄膜腫の薬物療法の現状を概説したい．

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