Nonsurgical Treatment Options in the Management of Intracranial Meningiomas

Department

Neurosurgery; Neurology

Document Type

Article

Abstract

Surgical resection is the treatment of choice for most intracranial meningiomas. We review the current state of adjuvant therapies, including radiation and chemotherapy. Conventional external beam radiation and stereotactic radiosurgery remain second-line options for patients unwilling or unable to undergo surgery. Radiation therapy is most useful in the setting of recurrent or residual tumor after surgical resection, where it is associated with a clear increase in the length of progression-free survival. This survival advantage is most pronounced with highgrade meningiomas, which have a much higher recurrence rate than low-grade meningiomas, even after gross total resection. In contrast, the role of chemotherapy in the treatment of meningiomas is limited. This treatment modality is often reserved for inoperable tumors or those refractory to radiation treatment. Furthermore, the choice of chemotherapy agents is limited. Hydroxyurea, a ribonucleotide reductase inhibitor, has modest clinical activity in meningiomas. In recent small clinical trials, somatostatin analogues have been moderately effective in controlling tumor growth.

Publication Date

2009

Publication Title

Frontiers in Bioscience - Elite

ISSN

1945-0494

Volume

1

Issue

2

First Page

494

Last Page

500

PubMed ID

19482663

Digital Object Identifier (DOI)

10.2741/e45

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