復發惡性腦膜瘤患者之補救性硼中子捕獲治療與照護系統

Treatment Outcomes and Care System of Salvage Boron Neutron Capture Therapy (BNCT) for Recurrent Malignant Meningioma Patients

陳一瑋(Yi-Wei Chen) ； 黃廷宇(Ting-Yu Huang) ； 穆佩芬(Pei-Fan Mu) ； 林俊甫(Chun-Fu Lin) ； 李宜燕(Yi-Yen Lee) ； 林可瀚(Ko-Han Lin) ； 賴律翰(Lu-Han Lai) ； 潘伯申(Po-Shen Pan) ； 田中浩基(Hiroki Tanaka) ； 郭于誠(Yu-Cheng Kuo) ； 李芃逸(Peng-Yi Lee) ； 李家誠(Jia-Cheng Lee) ； 劉鴻鳴(Hong-Ming Liu) ； 裴晉哲(Jinn-Jer Pei) ； 周鳳英(Fong-In Chou)

《秀傳醫學雜誌》 預刊文章 Pp. 1-18

https://doi.org/10.30185/SCMJ.202401/PP.0002

摘要

腦膜瘤是常見的中樞神經系統腫瘤，其源自神經組織外圍的結締組織突變，依其腫瘤表現分類為良性、非典型及惡性三類。惡性腦膜瘤處置以手術及放射治療為主，藥物僅有輔助角色。然而經標準治療後仍不幸復發者，尚缺乏有效的補救性處置。臺北榮總暨清華大學硼中子捕獲治療團隊自2017年起透過恩慈療法模式，對傳統療法失效的復發惡性腦瘤患者，提供硼中子捕獲治療之緊急醫療協助。除此之外，團隊亦提供了高品質的腫瘤治療照護系統，來改善治療後的復原效率，並兼顧身心全面的完整照護。本篇報告探討一位復發之腦膜瘤個案，經硼中子捕獲治療後成效甚佳，至今超過一年以上追蹤無復發，且無嚴重治療後不適症狀發生。此優質的醫療處置模式值得全面性的推廣。

關鍵字

腦膜瘤 ； 硼中子捕獲治療 ； 放射治療 ； 生活品質 ； 全人照護

並列摘要

Meningioma represents a commonly diagnosed central nervous system neoplasm in Taiwan. Etiologically, this tumor has been linked to mutations in the connective tissue adjacent to the brain. Based on the World Health Organization's classification system, meningiomas are categorized into three groups, reflecting their behavior: benign, atypical, and malignant. The primary therapeutic modalities for malignant meningioma encompass surgical resection and radiation therapy. Yet, advancements in pharmacological interventions remain scarce. In the clinical realm, recurrence following conventional surgery, radiotherapy, or adjunctive treatments is not an uncommon scenario for patients with malignant meningioma. Due to the dearth of potent salvage therapies, tumor recurrence frequently results in mortality. In 2017, the boron neutron capture therapy (BNCT) neuro-oncology teams of Taipei Veterans General Hospital and Tsinghua University pioneered an unique therapy model for recurrent malignant brain tumors (including meningioma). Employing this novel targeted particle radiation therapy, patients who have failed conventional therapy can achieve effective tumor control. Furthermore, the comprehensive team not only provided high-quality medical interventions, but also afforded holistic care to patients both physically and mentally. In this report, the disease course of a female patient with recurrent malignant meningioma was depicted. She was offered BNCT and there was neither cancer recurrence nor serious complications after treatment during more than one year of follow up. Such a commendable, high-caliber, and efficacious therapeutic modality certainly merits extensive investigation and endorsement.

並列關鍵字

meningioma ； boron neutron capture therapy ； radiotherapy ； quality of life ； holistic care