Grade 2 meningioma and radiosurgery

Area of Science:

• Neurosurgery
• Radiation Oncology
• Oncology

Background:

• World Health Organization Grade 2 meningiomas are aggressive tumors with high recurrence rates.
• Recurrence necessitates repeat surgeries, potentially worsening patient neurological status.
• The role of radiosurgery in managing Grade 2 meningiomas requires definition.

Purpose of the Study:

• To evaluate the efficacy of radiosurgery in controlling tumor progression.
• To assess radiosurgery for post-resection Grade 2 meningioma progression.
• To determine local and regional control rates after radiosurgery.

Main Methods:

• Retrospective study of 27 patients treated between 2000-2012.
• Patients underwent radiosurgery for radiologically proven progression of surgically treated Grade 2 meningioma.
• Analysis of progression-free survival and actuarial local/regional control rates.

Main Results:

• Mean progression-free survival was 32.4 months for target volume progression and 26.4 months for any intracranial meninges progression.
• 12-, 24-, and 36-month actuarial local control rates were 75%, 52%, and 40%.
• 12-, 24-, and 36-month actuarial regional control rates were 75%, 48%, and 33%. One transient hemiparesis case resolved without sequelae.

Conclusions:

• Radiosurgery is a safe and effective treatment for local control of delayed Grade 2 meningioma progression post-resection.
• Higher radiation doses, similar to those for malignant tumors, are recommended when feasible.
• Further investigation into optimal dosing for radiosurgery in meningioma management is warranted.