Skip to main content
SpringerLink
Log in

Stereotactic Radiosurgery for Meningioma

  • Chapter
  • First Online:
Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy

  • 1367 Accesses

Abstract

Meningioma is the most common primary intracranial tumor. Treatment alternatives for meningioma include surgery, radiotherapy, stereotactic radiosurgery (SRS), or a combination of these depending on patient- and tumor-specific factors. Meningioma outcomes are dictated by the extent of resection and other clinical and histopathologic features, including meningioma grade and setting, with outcomes from primary meningiomas being superior to outcomes from re-treatment of recurrent meningiomas; and patient age and medical comorbidities, much like meningioma size and location, may influence operative or other treatment decisions. For small meningiomas that are not immediately adjacent to critical structures such as the optic apparatus, single-fraction or fractionated SRS are safe and effective treatment alternatives to resection. In the adjuvant setting, SRS may also be used for incompletely resected meningiomas. Here, we provide a comprehensive review of the use of SRS for meningioma, with an emphasis on practical day-to-day considerations, and guidelines and applications for clinicians.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ostrom QT, Gittleman H, Fulop J, Liu M, Blanda R, Kromer C, et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2008–2012. Neuro-oncology. Oxford University Press. 2015;17(Suppl 4):iv1–iv62.

    Article  Google Scholar 

  2. Vernooij MW, Ikram MA, Tanghe HL, Vincent AJPE, Hofman A, Krestin GP, et al. Incidental findings on brain MRI in the general population. N Engl J Med. 2007;357(18):1821–8.

    Article  CAS  Google Scholar 

  3. Barthélemy EJ, Sarkiss CA, Lee J, Shrivastava RK. The historical origin of the term “meningioma” and the rise of nationalistic neurosurgery. J Neurosurg. 2016;125(5):1283–90.

    Article  Google Scholar 

  4. Cushing H. The meningiomas (dural endotheliomas): their source, and favoured seats of origin. Brain. 1922;45(2):282–316.

    Article  Google Scholar 

  5. Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol. Springer Berlin Heidelberg. 2016;131(6):803–20.

    Article  Google Scholar 

  6. Rogers L, Barani I, Chamberlain M, Kaley TJ, McDermott M, Raizer J, et al. Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review. J Neurosurg. 2015;122(1):4–23.

    Article  Google Scholar 

  7. Wen PY, Quant E, Drappatz J, Beroukhim R, Norden AD. Medical therapies for meningiomas. J Neurooncol. Springer US. 2010;99(3):365–78.

    Article  CAS  Google Scholar 

  8. Combs SE, Thilmann C, Edler L, Debus J, Schulz-Ertner D. Efficacy of fractionated stereotactic reirradiation in recurrent gliomas: long-term results in 172 patients treated in a single institution. J Clin Oncol. 2005;23(34):8863–9.

    Article  Google Scholar 

  9. Kondziolka D, Levy EI, Niranjan A, Flickinger JC, Lunsford LD. Long-term outcomes after meningioma radiosurgery: physician and patient perspectives. J Neurosurg. 1999;91(1):44–50.

    Article  CAS  Google Scholar 

  10. Sughrue ME, Rutkowski MJ, Aranda D, Barani IJ, McDermott MW, Parsa AT. Treatment decision making based on the published natural history and growth rate of small meningiomas. J Neurosurg. 2010;113(5):1036–42.

    Article  Google Scholar 

  11. Santacroce A, Walier M, Régis J, Liščák R, Motti E, Lindquist C, et al. Long-term tumor control of benign intracranial meningiomas after radiosurgery in a series of 4565 patients. Neurosurgery. 2012;70(1):32–9. –discussion 39.

    Article  Google Scholar 

  12. Kondziolka D, Mathieu D, Lunsford LD, Martin JJ, Madhok R, Niranjan A, et al. Radiosurgery as definitive management of intracranial meningiomas. Neurosurgery. 2008;62(1):53–8. –discussion 58–60.

    Article  Google Scholar 

  13. Kaprealian T, Raleigh DR, Sneed PK, Nabavizadeh N, Nakamura JL, McDermott MW. Parameters influencing local control of meningiomas treated with radiosurgery. J Neurooncol. Springer US. 2016;128(2):357–64.

    Article  CAS  Google Scholar 

  14. Bria C, Wegner RE, Clump DA, Vargo JA, Mintz AH, Heron DE, et al. Fractionated stereotactic radiosurgery for the treatment of meningiomas. J Cancer Res Ther. Medknow Publications. 2011;7(1):52–7.

    Article  Google Scholar 

  15. Han M-S, Jang W-Y, Moon K-S, Lim S-H, Kim I-Y, Jung T-Y, et al. Is fractionated gamma knife radiosurgery a safe and effective treatment approach for large-volume (>10 cm3) intracranial meningiomas? World Neurosurg. 2017;99:477–83.

    Article  Google Scholar 

  16. Sheehan JP, Cohen-Inbar O, Ruangkanchanasetr R, Bulent Omay S, Hess J, Chiang V, et al. Post-radiosurgical edema associated with parasagittal and parafalcine meningiomas: a multicenter study. J Neuro-Oncol. 2015;125(2):317–24.

    Article  Google Scholar 

  17. Cai R, Barnett GH, Novak E, Chao ST, Suh JH. Principal risk of peritumoral edema after stereotactic radiosurgery for intracranial meningioma is tumor-brain contact interface area. Neurosurgery. 2010;66(3):513–22.

    Article  Google Scholar 

  18. Darzy KH, Shalet SM. Hypopituitarism following radiotherapy. Pituitary. Springer US. 2009;12(1):40–50.

    Article  Google Scholar 

  19. Sethi RA, Rush SC, Liu S, Sethi SA, Parker E, Donahue B, et al. Dose-response relationships for meningioma radiosurgery. Am J Clin Oncol. 2015;38(6):600–4.

    Article  Google Scholar 

  20. Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B, et al. Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys. 2010;37(8):4078–101.

    Article  Google Scholar 

  21. Kollová A, Liščák R, Novotný J Jr, Vladyka V, Šimonová G, Janoušková L. Gamma Knife surgery for benign meningioma. J Neurosurg. 2007;107(2):325–36.

    Article  Google Scholar 

  22. Bi WL, Abedalthagafi M, Horowitz P, Agarwalla PK, Mei Y, Aizer AA, et al. Genomic landscape of intracranial meningiomas. J Neurosurg. 2016;125(3):1–11.

    Article  Google Scholar 

  23. Clark VE, Erson-Omay EZ, Serin A, Yin J, Cotney J, Ozduman K, et al. Genomic analysis of non-NF2 meningiomas reveals mutations in TRAF7, KLF4, AKT1, and SMO. Science. 2013;339(6123):1077–80.

    Article  CAS  Google Scholar 

  24. Sahm F, Bissel J, Koelsche C, Schweizer L, Capper D, Reuss D, et al. AKT1E17K mutations cluster with meningothelial and transitional meningiomas and can be detected by SFRP1 immunohistochemistry. Acta Neuropathol. 2013;126(5):757–62.

    Article  CAS  Google Scholar 

  25. Clark VE, Harmancı AS, Bai H, Youngblood MW, Lee TI, Baranoski JF, et al. Recurrent somatic mutations in POLR2A define a distinct subset of meningiomas. Nat Genet. 2016;48(10):1253–9.

    Article  CAS  Google Scholar 

  26. Bi WL, Greenwald NF, Abedalthagafi M, Wala J, Gibson WJ, Agarwalla PK, et al. Genomic landscape of high-grade meningiomas. NPJ Genom Med. 2017;2(1):iv1.

    Article  Google Scholar 

  27. Reuss DE, Piro RM, Jones DTW, Simon M, Ketter R, Kool M, et al. Secretory meningiomas are defined by combined KLF4 K409Q and TRAF7 mutations. Acta Neuropathol. 2013;125(3):351–8.

    Article  CAS  Google Scholar 

  28. Sahm F, Schrimpf D, Stichel D, Jones DTW, Hielscher T, Schefzyk S, et al. DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis. Lancet Oncol. 2017;18(5):682–94.

    Article  CAS  Google Scholar 

  29. Harmanci AS, Youngblood MW, Clark VE, Coşkun S, Henegariu O, Duran D, et al. Integrated genomic analyses of de novo pathways underlying atypical meningiomas. Nat Commun. 2017;8:14433.

    Article  CAS  Google Scholar 

  30. Du Z, Abedalthagafi M, Aizer AA, McHenry AR, Sun HH, Bray M-A, et al. Increased expression of the immune modulatory molecule PD-L1 (CD274) in anaplastic meningioma. Oncotarget. Impact Journals. 2015;6(7):4704–16.

    Google Scholar 

  31. Han SJ, Reis G, Kohanbash G, Shrivastav S, Magill ST, Molinaro AM, et al. Expression and prognostic impact of immune modulatory molecule PD-L1 in meningioma. J Neurooncol. Springer US. 2016;130(3):543–52.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of California at San Francisco, Departments of Radiation Oncology and Neurological Surgery, San Francisco, CA, USA

    David R. Raleigh

  2. University of California at San Francisco, Departments of Radiation Oncology, San Francisco, CA, USA

    Penny K. Sneed

Authors
  1. David R. Raleigh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Penny K. Sneed
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David R. Raleigh .

Editor information

Editors and Affiliations

  1. Mayo Clinic, Radiation Oncology, Mayo Clinic School of Medicine Radiation Oncology, Jacksonville, FL, USA

    Daniel M. Trifiletti

  2. Department of Radiation Oncology, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH, USA

    Samuel T. Chao

  3. Sunnybrook Odette Cancer Centre, Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada

    Arjun Sahgal

  4. University of Virginia, Departments of Neurological Surgery and Radiation Oncology, Charlottesville, VA, USA

    Jason P. Sheehan

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Raleigh, D.R., Sneed, P.K. (2019). Stereotactic Radiosurgery for Meningioma. In: Trifiletti, D., Chao, S., Sahgal, A., Sheehan, J. (eds) Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-16924-4_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-16924-4_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16923-7

  • Online ISBN: 978-3-030-16924-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation