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Radiation Therapy for Low Grade Meningiomas

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Meningiomas

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Abstract

Radiation therapy (RT) has been used to treat benign meningioma in many forms and capacities over the decades, with goals of definitive, adjuvant, salvage, and/or palliative treatment. In selected patient cohorts, definitive radiotherapy has a local control rate comparable to surgery. Although surgical resection is often the preferred treatment option if available, benign meningioma frequently grows in confined spaces such as the base of skull, cavernous sinus, and around the optic sheath, limiting resectability. For asymptomatic and inoperable patients with small tumors that are not abutting critical structures, stereotactic radiosurgery can be considered. In patients with large or symptomatic lesions, surgical debulking with postoperative radiosurgery or fractionated radiation therapy is delivered to residual disease. The RT treatment modality choice is dependent on multiple clinical, radiographic, and histopathologic features. This chapter will explore the indications and appropriate patient selection for definitive radiation for benign meningioma and detail the factors one should consider when choosing fractionated therapy versus radiosurgery. Additionally, the available techniques and treatment planning logistics will be outlined. Lastly, radiation side effects will be detailed, along with special considerations such as radiation in the setting of autoimmune disease, radiation-induced meningioma, and radiation in patients with genetic disorders such as neurofibromatosis type 2 (NF2).

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Author information

Authors and Affiliations

  1. Yale Department of Therapeutic Radiology, New Haven, CT, USA

    Gabrielle W. Peters

  2. Department of Therapeutic Radiology, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA

    Joseph N. Contessa

Authors
  1. Gabrielle W. Peters
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  2. Joseph N. Contessa
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Correspondence to Gabrielle W. Peters .

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Editors and Affiliations

  1. Department of Neurosurgery, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA

    Jennifer Moliterno

  2. Department of Neurology, Yale School of Medicine, Yale New Haven Hospital, New Haven, CT, USA

    Antonio Omuro

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Peters, G.W., Contessa, J.N. (2020). Radiation Therapy for Low Grade Meningiomas. In: Moliterno, J., Omuro, A. (eds) Meningiomas. Springer, Cham. https://doi.org/10.1007/978-3-030-59558-6_9

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