The Role of Radiotherapy in the Management of Intracranial Meningiomas

Abstract

INTRODUCTION: Cerebral meningiomas account for 15–20% of all cerebral tumors. Although seldom malignant, they frequently recur in spite of complete surgery, which remains the cornerstone of the treatment. In order to decrease the probability of local recurrence, radiotherapy has often been recommended in atypical or malignant meningioma as well as in benign meningioma which was incompletely resected. However, this treatment never was the subject of prospective studies, randomized or not. METHODS: We retrospectively reviewed all patients with meningioma treated with radiotherapy in the oncology department of Hospital University Mohammed 6 in Marrakech from 1 January 2011 to 1 December 2014. Demographic data including age, sex, and clinical signs revealing meningioma Been studied. All patients in the study received surgical treatment and radiotherapy. The histological data of the surgical specimens have been studied, neurological evolution and therapeutic complications were analyzed. RESULTS : From January 2011 to December 2014, six patients were identified with a median age of 43.5 years (range 25-56years). Sex-ratio was 0.5. Headache was the most common presenting symptom manifesting in 4 patients (66,6 %). Tumors were mostly located in the convexity (83.3%). Five patients underwent complete excision (Simpson I A III) and 1 underwent subtotal excision (Simpson IV). On histopathological analysis, 2 patients (33,3%) had WHO grade I, 2 patients (33,3%) had WHO grade II (atypical) and 2 patients (33,3%) grade III. 4 patients had adjuvant radiation from initial management and 2 patients with grade I meningioma had adjuvant radiotherapy after recurrence and surgical reoperation. For evolution, a tumor recurrence was observed at control imaging in the 12th months, the disease was stabilized for the patient with sphenoorbital localization, for the remaining four patients, the disease was controlled. No grade 3 or 4 toxicity were observed. ca—a½“ao•c«¯ CONCLUSION: Adjuvant radiotherapy improved local control after incomplete resection for grade I meningiomas, and after complete resection for high-grade meningiomas.