Clinicopathologic Features of Aggressive Meningioma Emphasizing the Role of Radiotherapy in Treatment

Engenhart‐Cabillic, Rita; Farhoud, Ahmed; Sure, Ulrich; Heinze, Stefan; Henzel, Martin; Mennel, H. D.; Bertalanffy, Helmut

doi:10.1007/s00066-006-1555-3

Cited by 56 publications

(35 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We are aware of the reported 37% recurrence rate for "nonbenign meningiomas" without formal radiation therapy, 5 and at our institution the radiation oncologists frequently favor more aggressive radiation treatment than neurosurgeons. In our experience, however, the potential cognitive effects of radiation therapy often outweigh the benefit of a reduction in tumor recurrence.…”

Section: Discussionmentioning

confidence: 93%

Hitting a moving target: evolution of a treatment paradigm for atypical meningiomas amid changing diagnostic criteria

Pearson¹,

Markert²,

Fisher³

et al. 2008

FOC

183

View full text Add to dashboard Cite

Object The World Health Organization (WHO) reclassified atypical meningiomas in 2000, creating a more clear and broadly accepted definition. In this paper, the authors evaluated the pathological and clinical transition period for atypical meningiomas according to the implementation of the new WHO grading system at their institution. Methods A total of 471 meningiomas occurring in 440 patients between 1994 and 2006 were retrospectively reviewed to determine changes in diagnostic rates, postoperative treatment trends, and early outcomes. Results Between 1994 and 2000, the incidence of the atypical meningiomas ranged from 0 to 3/year, or 4.4% of the meningiomas detected during the entire period. After 2002, the annual percentage of atypical meningiomas rose over a 2-year period, leveling off at between 32.7 and 35.5% between 2004 and 2006. The authors also found a recent trend toward increased use of adjuvant radiation therapy for incompletely resected atypical meningiomas. Prior to 2003, 18.7% were treated with this therapy; after 2003, 34.4% of lesions received this treatment. Incompletely resected tumors were treated with some form of radiation 76% of the time. In cases of complete resection, most patients were not given adjuvant therapy but were expectantly managed by close monitoring using serial imaging and by receiving immediate treatment for tumor recurrence. The overall recurrence rate for expectantly managed tumors was 9% over 28.2 months, and 75% of recurrences responded to delayed radiation therapy. Conclusions The authors documented a significant change in the proportion of meningiomas designated as atypical during a transition period from 2002 to 2004, and propose a conservative strategy for the use of radiation therapy in atypical meningiomas.

show abstract

Section: Discussionmentioning

confidence: 93%

Hitting a moving target: evolution of a treatment paradigm for atypical meningiomas amid changing diagnostic criteria

Pearson¹,

Markert²,

Fisher³

et al. 2008

FOC

183

View full text Add to dashboard Cite

show abstract

“…Repeated surgeries are associated with in creased morbidity, which can seriously affect a patient's quality of life. 22 Recently, committees of neurooncologists have proposed performing external radiotherapy at an early stage in patients with Grade 2 or 3 meningiomas 1,2,7 to improve progressionfree survival time. However, ra diotherapy is not without risk.…”

Section: Natural History Of Grade 2 Meningiomamentioning

confidence: 99%

Grade 2 meningioma and radiosurgery

Aboukaïs¹,

Zaïri²,

Lejeune³

et al. 2015

JNS

View full text Add to dashboard Cite

OBJECT World Health Organization Grade 2 meningiomas are aggressive tumors associated with a high recurrence rate leading to repeated surgical procedures, which can seriously worsen a patient's neurological status. Although radiosurgery is an increasingly popular technique, its role in the management of Grade 2 meningiomas has yet to be defined. In this study the authors aimed to evaluate radiosurgery in achieving control of proven tumor progression occurring after resection of Grade 2 meningioma. METHODS This retrospective study included consecutive patients who, between 2000 and 2012, had undergone radiosurgery for radiologically proven progression of a previously surgically treated Grade 2 meningioma. RESULTS Twenty-seven patients were eligible for analysis. There were 9 men and 18 women with a mean age of 59 years. The mean radiation dose was 15.2 Gy (range 12–21 Gy), and the mean target volume was 5.4 cm3 (range 0.194–14.2 cm3). Thirty-four radiosurgical procedures were performed in the 27 patients. The mean progression-free survival after radiosurgery was 32.4 months among those with progression in a target irradiated volume and 26.4 months among those with progression in any intracranial meninges. With a mean follow-up of 56.4 months (range 12–108 months), the 12-, 24-, and 36-month actuarial local control rates for all patients were 75%, 52%, and 40%, respectively, and the regional control rates were 75%, 48%, and 33%. A single case of transient hemiparesis completely resolved without sequelae. CONCLUSIONS Radiosurgery appears to be a safe and effective treatment for the local control of delayed progression after resection of a Grade 2 meningioma. Higher radiation doses similar to those applied for malignant tumors should be recommended when possible.

show abstract

“…The role of adjuvant radiation therapy on meningioma remains unclear, but appears to be effective in the treatment of malignant meningiomas. 21,22 However, the relatively short postoperative follow-up period (ranged from 11 months to 39 months; mean, 23.1 months) can also attribute some of the differences in recurrence rates. Further long-term follow-up studies will be needed.…”

Section: 820mentioning

confidence: 99%