Radiation therapy of meningioma

Radiation therapy is an option as a primary treatment for small meningiomas and for treatment of recurrences after surgery. The technology for delivery of treatment has advanced much in the last 15 years, and now image guidance and stereotactic methods are used for defining the target location. There are different forms of treatment that include protons and photons, both delivered using multiple beam paths converging on the target. Currently the most common form of treatment uses photon energy derived from a linear accelerator using intensity modulated techniques. Radiation delivered in multiple sessions, more than five, is termed fractionated treatment, whereas those using five or less have been referred to radiosurgery. This chapter outlines the usefulness of radiation in the management of meningioma.