TY - JOUR
T1 - Radiation for skull base meningiomas
T2 - Review of the literature on the approach to radiotherapy
AU - Moraes, Fabio Y.
AU - Chung, Caroline
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Skull base meningiomas (SBM) pose unique challenges for radiotherapy as these tumors are often in close proximity to a number of critical structures and may not be surgically addressed in many cases, leaving the question about the tumor grade and expected biological behaviour. External beam radiotherapy and radiosurgery are longstanding treatments for meningioma that are typically used as upfront primary therapy, for recurrent tumors and as adjuvant therapy following surgical resection. There is controversy regarding the optimal timing and approach for radiation therapy in various clinical settings such as the role of adjuvant radiotherapy for completely resected grade 2 tumours. Despite the use of radiotherapy for many decades, the evidence to guide optimal radiation treatment is limited largely to single institution series of EBRT, SRS and particle therapy. In this article, we review the published data to clarify the role of external beam radiotherapy, proton radiotherapy and single and multi-fraction radiosurgery for SBM. We also highlight the areas of potential research and need for clinical improvement, including the growing awareness and effort to improve cognitive function in this patient population, who typically have long life expectancy following their meningioma diagnosis. Chinese Clinical Oncology.
AB - Skull base meningiomas (SBM) pose unique challenges for radiotherapy as these tumors are often in close proximity to a number of critical structures and may not be surgically addressed in many cases, leaving the question about the tumor grade and expected biological behaviour. External beam radiotherapy and radiosurgery are longstanding treatments for meningioma that are typically used as upfront primary therapy, for recurrent tumors and as adjuvant therapy following surgical resection. There is controversy regarding the optimal timing and approach for radiation therapy in various clinical settings such as the role of adjuvant radiotherapy for completely resected grade 2 tumours. Despite the use of radiotherapy for many decades, the evidence to guide optimal radiation treatment is limited largely to single institution series of EBRT, SRS and particle therapy. In this article, we review the published data to clarify the role of external beam radiotherapy, proton radiotherapy and single and multi-fraction radiosurgery for SBM. We also highlight the areas of potential research and need for clinical improvement, including the growing awareness and effort to improve cognitive function in this patient population, who typically have long life expectancy following their meningioma diagnosis. Chinese Clinical Oncology.
KW - Cognition
KW - Meningioma
KW - Proton
KW - Radiation therapy radiosurgery
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U2 - 10.21037/cco.2017.06.08
DO - 10.21037/cco.2017.06.08
M3 - Review article
C2 - 28758407
AN - SCOPUS:85024888534
SN - 2304-3865
VL - 6
JO - Chinese clinical oncology
JF - Chinese clinical oncology
M1 - S3
ER -