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Radiotherapy for atypical meningiomas.

Richard Mair1, Kevin Morris, Ian Scott

  • 1Department of Neurosurgery, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, USA.

Journal of Neurosurgery
|June 25, 2011
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Postoperative radiotherapy is not recommended after gross-total resection of WHO Grade II meningiomas. Radiosurgery is advised for residual tumor, with radiotherapy reserved for large remnants unsuitable for radiosurgery.

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Oncology

Background:

  • The role of postoperative radiotherapy for WHO Grade II meningiomas is debated.
  • Existing literature often uses outdated WHO grading criteria.

Purpose of the Study:

  • To investigate the efficacy of postoperative radiotherapy in patients with WHO Grade II meningiomas using current diagnostic criteria.
  • To clarify treatment guidelines for atypical meningiomas after initial surgical resection.

Main Methods:

  • Retrospective analysis of 114 patients with WHO Grade II meningiomas diagnosed using 2000 WHO criteria.
  • Evaluation of outcomes, including radiological recurrence, using Kaplan-Meier and Cox regression analyses.
  • Varied use of postoperative radiotherapy based on surgeon preference.

Main Results:

  • Postoperative radiotherapy showed benefit only when gross-total resections and subtotal resections with radiosurgery were excluded.
  • This suggests radiotherapy's benefit is limited in specific resection scenarios.

Conclusions:

  • Radiotherapy is not indicated after gross-total resection (Simpson Grade 1 or 2) of WHO Grade II meningiomas.
  • Radiosurgery is recommended for residual tumor after initial resection.
  • Postoperative radiotherapy should be reserved for unresectable remnants where radiosurgery is not feasible.