oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2022-21-4-110-123oncotomsk-2247Research ArticleОБЗОРЫREVIEWSИнтракраниальные менингиомы: клинико-интраскопические и патоморфологические причины рецидивирования с учетом современных методов лечения (обзор литературы)Intracranial meningiomas: clinical, intrascopic and pathomorphological causes of recurrence (literature review)https://orcid.org/0000-0002-1123-8271КукановК. К.KukanovK. K.

Куканов Константин Константинович - кандидат медицинских наук, научный сотрудник НИЛ нейроонкологии.

191014, Санкт-Петербург, ул. Маяковского, 12.

Konstantin K. Kukanov - MD, PhD, Researcher, Research Laboratory of Neurooncology, Russian Research Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.А. Almazov, Ministry of Health of the Russia.

12, Mayakovsky St., 191014, St. Petersburg.

outhall.88@mail.ruhttps://orcid.org/0000-0002-1349-7349ВоробьёваО. М.VorobyovaO. M.

Воробьёва Ольга Михайловна - кандидат медицинских наук, старший научный сотрудник НИЛ патоморфологии нервной системы.

191014, Санкт-Петербург, ул. Маяковского, 12.

Olga M. Vorobyova - MD, PhD, Senior Researcher, Research Laboratory of Pathomorphology of the Nervous System, Russian Research Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.А. Almazov, Ministry of Health of the Russia.

12, Mayakovsky St., 191014, St. Petersburg.

https://orcid.org/0000-0001-6206-2133ЗабродскаяЮ. М.ZabrodskayaYu. M.

Забродская Юлия Михайловна - доктор медицинских наук, заведующая НИЛ патоморфологии нервной системы.

191014, Санкт-Петербург, ул. Маяковского, 12.

Yulia M. Zabrodskaya - MD, DSc, Head of the Research Laboratory of Pathomorphology of the Nervous System, Russian Research Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.А. Almazov, Ministry of Health of the Russia.

12, Mayakovsky St., 191014, St. Petersburg.

https://orcid.org/0000-0003-0449-9163ПотёмкинаЕ. Г.PotemkinaE. G.

Потёмкина Елена Геннадьевна - доктор медицинских наук, ведущий научный сотрудник, врач-рентгенолог отделения лучевой диагностики.

191014, Санкт-Петербург, ул. Маяковского, 12.

Elena G. Potemkina - MD, DSc, Senior Researcher, Radiologist, Department of Radiation Diagnostics, Russian Research Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.А. Almazov of the Ministry of Health of the Russia.

12, Mayakovsky St., 191014, St. Petersburg.

https://orcid.org/0000-0002-4091-7396УшановВ. В.UshanovV. V.

Ушанов Всеслав Всеволодович - клинический ординатор кафедры нейрохирургии.

197341, Санкт-Петербург, ул. Аккуратова, 2.

Vseslav V. Ushanov - Сlinical Resident of the Department of Neurosurgery, National Medical Research Center named after V.A. Almazov, Ministry of Health of the Russian Federation.

2, Akkuratova St., 197341, St. Petersburg.

https://orcid.org/0000-0003-3675-9302ТастанбековМ. М.TastanbekovM. M.

Тастанбеков Малик Маратович - доктор медицинских наук, руководитель отделения нейрохирургии № 6.

197341, Санкт-Петербург, ул. Аккуратова, 2.

Malik M. Tastanbekov - MD, DSc, Head of the Department of Neurosurgery № 6, National Medical Research Center named after V.A. Almazov of the Ministry of Health of the Russia.

2, Akkuratova St., 197341, St. Petersburg.

https://orcid.org/0000-0003-2790-0191ИвановаН. Е.IvanovaN. E.

Иванова Наталия Евгеньевна - доктор медицинских наук, профессор, заведующая научным отделом.

191014, Санкт-Петербург, ул. Маяковского, 12.

Natalia E. Ivanova - MD, Professor, Head of the Scientific Department, Russian Research Neurosurgical Institute named after Professor A.L. Polenov – a branch of National Medical Research Center named after V.А. Almazov of the Ministry of Health of the Russia.

12, Mayakovsky St., 191014, St. Petersburg.

Российский научно-исследовательский нейрохирургический институт им. проф. А.Л. Поленова» – филиал ФГБУ «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава РоссииРоссияPolenov Neurosurgical Institute – the branch of Almazov National Medical Research CentreRussian FederationНациональный медицинский исследовательский центр им. В.А. Алмазова Минздрава РоссииРоссияAlmazov National Medical Research CentreRussian Federation202203092022214110123Copyright © Куканов К.К., Воробьёва О.М., Забродская Ю.М., Потёмкина Е.Г., Ушанов В.В., Тастанбеков М.М., Иванова Н.Е., 20222022Куканов К.К., Воробьёва О.М., Забродская Ю.М., Потёмкина Е.Г., Ушанов В.В., Тастанбеков М.М., Иванова Н.Е.Kukanov K.K., Vorobyova O.M., Zabrodskaya Y.M., Potemkina E.G., Ushanov V.V., Tastanbekov M.M., Ivanova N.E.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/2247

Введение. Менингиомы – часто встречающиеся опухоли центральной нервной системы, у взрослых занимают 2-е место, уступая лишь глиомам. Большинство менингиом имеют доброкачественный характер течения. Анапластические и атипические менингиомы, которые составляют 25 %, имеют рецидивирующий тип течения заболевания даже после радикального удаления опухоли и проведения радиотерапии. Прогноз у больных с анапластическими менингиомами остается неутешительным, и большинство из них погибает в первые 2–5 лет после операции. Цель исследования – по литературным данным оценить состояние проблемы диагностики и лечения менингиом, имеющих рецидивирующие течение, выявить причины опухолевой прогрессии, особенности клинической картины, лучевой диагностики, специфики патоморфологических и молекулярно-генетических характеристик. Материал и методы. Осуществлен поиск печатных работ в базах данных Pubmed, EMBASE, Cohrane Library и eLibrary, опубликованных в период с января 2000 г. по январь 2019 г. по вопросу рецидивирования внутричерепных менингиом, в частности атипических и анапластических. Результаты. Систематизированы данные по прогностическим критериям диагностики менингиом, влияющим на выживаемость, безрецидивный период, прогрессирование процесса. Уделено внимание радикальности операции и оценке степени анаплазии. Представлены современные сведения о лучевой терапии и медикаментозном лечении, обсуждены результаты исследований по их эффективности. Затронуты спорные вопросы подходов в оценке морфологических прогностических критериев. Приведены последние сведения о наиболее часто встречающихся генетических мутациях в менингиомах, перспективах их изучения и использования для таргетнтной терапии. Заключение. Проблема ведения больных с менингиомами еще далека до своего окончательного решения, отсутствуют оптимальные стандарты диагностики и лечения пациентов с менингиомами, учитывающие биологические особенности, в том числе особенности роста, молекулярно-генетический профиль. Нет четких прогностических критериев рецидива и преемственности в дальнейшей курации после хирургического лечения, что влияет на уровень смертности и качество жизни данной категории пациентов.

Introduction. Meningiomas are the second most common central nervous system (CNS) tumors in adults. most meningiomas are benign tumors. Anaplastic and atypical meningiomas account for 25% and have a high recurrence rate even after radical tumor resection and radiotherapy. The prognosis of patients with anaplastic meningiomas remains disappointing; most of them die within the first 2 to 5 years after surgery. Purpose: to discuss the challenges in diagnosis and treatment of recurrent meningiomas, to identify the causes of tumor progression, and to assess the clinical features and radiographic findings as well as specific pathomorphological and molecular genetic characteristics. material and methods. We searched for publications in the Pubmed, EMBASE, Cohrane Library and eLibrary databases published between January 2000 and January 2019 on the issue of recurrent intracranial meningiomas, in particular atypical and anaplastic meningiomas. Results. The review systematizes data on the prognostic factors for survival, relapse-free period, and disease progression. particular attention was paid to the radical resection of the tumor and the assessment of the grade of anaplasia. The current data on radiotherapy and drug therapy were presented.  the controversial issues of approaches to the assessment of morphological prognostic criteria were discussed. The current knowledge on the most common genetic mutations in meningiomas, the prospects for their study and use for targeted therapy were presented. Conclusion. The management of meningioma still presents some unresolved issues.  There are no optimal standards for diagnosis and treatment of patients with meningiomas that would take into account biological characteristics, including growth characteristics and molecular genetic profile. There are no clear prognostic criteria for recurrence and continuity in further management after surgical treatment, which affects the mortality rate and quality of life in this category of patients. New fundamental data that will determine a different strategy in the treatment of intracranial meningiomas are needed.

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The authors declare that there are no conflicts of interest present.