Ways to personalize the treatment of patients with relapse and continued growth of intracranial meningiomas

Abstract

Purpose. According to the literature, to assess the state of the problem of diagnosis and treatment of meningiomas with recurrent course, to identify the causes of tumor progression, features of the clinical picture, radiology diagnostics, the specificity of pathomorphological and molecular genetic characteristics.Materials and methods. We searched for publications in the Pubmed, EMBASE, Cohrane Library and eLibrary databases published between January 2000 and January 2019 on the issue of recurrent intracranial meningiomas, in particular atypical and anaplastic.Results. The review systematizes data on the prognostic criteria for diagnosing meningiomas that affect survival, relapse-free period, and the progression of the neoplastic process. Particular attention is paid to the radicality of the operation and the assessment of the degree of anaplasia. The present day information on radiation therapy and drug treatment is presented, the results of studies on their effectiveness are discussed. The controversial issues of approaches to the assessment of morphological prognostic criteria are touched upon. The latest information on the most common genetic mutations in meningiomas, the prospects for their study and use for targeted therapy are presented. The authors come to the conclusion that the problem of managing patients with meningiomas is still far from its final solution; there are no optimal standards for the diagnosis and treatment of patients with meningiomas, taking into account biological characteristics, including growth characteristics, molecular genetic profile. There are no clear prognostic criteria for recurrence and continuity in further supervision after surgical treatment, which cannot but affect the mortality rate and quality of life of this category of patients.