Marosi C et al. - In a review of the state of treatment of meningioma, medical therapy for pts with recurrent, progressive and symptomatic disease after repeated surgery, radiosurgery, and radiotherapy is investigational. Hormonal therapy with progesterone antagonists has shown modest results, while chemotherapy with hydroxyurea appears moderately active Methods
Meningiomas are mostly benign tumours originating from the arachnoid cap cells, represent 13–26% of all intracranial tumours
They are more common in older age and in females
Deletion in NF2 gene and exposure to ionizing radiation are established risk factors, while the role of sex hormones is yet not clarified
5-year survival for typical meningiomas exceeds 80%, but is poorer in malignant and atypical meningiomas
Papillary and haemangiopericytic morphology, large tumour size, high mitotic index, absence of progesterone receptors, deletions, and loss of heterozygosity are poor prognostic factors
Complete surgical excision is the standard treatment
Radiotherapy is currently used in the clinical practice in atypical, malignant, or recurrent meningioma at a total dose of 45–60 Gy
Results
The role of adjuvant irradiation is still controversial and has to be compared in a randomised prospective setting with a policy of watchful waiting
Radiosurgery has gained more and more importance in the management of meningiomas, especially in meningiomas that cannot be completely resected as for many skull base meningiomas
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