Meningioma medical therapy: Difference between revisions

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* Conservative management with observation and close imaging follow-up is recommended among certain patients with<br> small sized [[asymptomatic]] meningioma.<ref name="pmid15452322">{{cite journal| author=Herscovici Z, Rappaport Z, Sulkes J, Danaila L, Rubin G| title=Natural history of conservatively treated meningiomas. | journal=Neurology | year= 2004 | volume= 63 | issue= 6 | pages= 1133-4 | pmid=15452322 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15452322  }} </ref><ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>
* Conservative management with observation and close imaging follow-up is recommended among certain patients with<br> small sized [[asymptomatic]] meningioma.<ref name="pmid15452322">{{cite journal| author=Herscovici Z, Rappaport Z, Sulkes J, Danaila L, Rubin G| title=Natural history of conservatively treated meningiomas. | journal=Neurology | year= 2004 | volume= 63 | issue= 6 | pages= 1133-4 | pmid=15452322 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15452322  }} </ref><ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>
* Meningioma among patients younger than 60 years of age are more likely to grow in size on repeated imaging studies; thus<br> conservative management is not recommended among such patients.<ref name="pmid15452322">{{cite journal| author=Herscovici Z, Rappaport Z, Sulkes J, Danaila L, Rubin G| title=Natural history of conservatively treated meningiomas. | journal=Neurology | year= 2004 | volume= 63 | issue= 6 | pages= 1133-4 | pmid=15452322 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15452322  }} </ref><ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>
* Meningioma among patients younger than 60 years of age are more likely to grow in size on repeated imaging studies; thus<br> conservative management is not recommended among such patients.<ref name="pmid15452322">{{cite journal| author=Herscovici Z, Rappaport Z, Sulkes J, Danaila L, Rubin G| title=Natural history of conservatively treated meningiomas. | journal=Neurology | year= 2004 | volume= 63 | issue= 6 | pages= 1133-4 | pmid=15452322 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15452322  }} </ref><ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>
* Conservative management is not recommended among meningioma patients who are already [[symptomatic]].<ref name="pmid15452322">{{cite journal| author=Herscovici Z, Rappaport Z, Sulkes J, Danaila L, Rubin G| title=Natural history of conservatively treated meningiomas. | journal=Neurology | year= 2004 | volume= 63 | issue= 6 | pages= 1133-4 | pmid=15452322 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15452322  }} </ref><ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>
* Conservative management is not recommended among symptomatic meningioma patients.<ref name="pmid15452322">{{cite journal| author=Herscovici Z, Rappaport Z, Sulkes J, Danaila L, Rubin G| title=Natural history of conservatively treated meningiomas. | journal=Neurology | year= 2004 | volume= 63 | issue= 6 | pages= 1133-4 | pmid=15452322 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15452322  }} </ref><ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>




Line 23: Line 23:
'''Chemotherapy'''
'''Chemotherapy'''
* [[Chemotherapeutic agent]]s are generally not effective against meningioma.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>  
* [[Chemotherapeutic agent]]s are generally not effective against meningioma.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>  
* [[Antiprogestin]] agents have been used, but with variable results.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>  
* [[Antiprogestin]] agents have been used to treat meningioma but with variable results.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>  
* Recent evidence that [[hydroxyurea]] has the capacity to shrink unresectable or recurrent meningiomas is being further evaluated.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>
* Recent evidence that [[hydroxyurea]] has the capacity to shrink unresectable or recurrent meningiomas is being further evaluated.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref>



Revision as of 15:57, 28 September 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Overview

In asymptomatic meningiomas, the decision of surgical resection must be weighed against the possibility of conservative management according to the patient's age, clinical presentation, and the anatomical location of the tumor.[1][2] Current data suggest that both external beam radiotherapy and radiosurgery play an important role in the management of grade II and III meningiomas.[2][3][4] Chemotherapeutic agents are generally not effective against meningioma.[2]

Medical Therapy

Conservative management

  • In asymptomatic meningiomas, the decision of surgical resection must be weighed against the possibility of conservative
    management according to the patient's age, clinical presentation, and the anatomical location of the tumor.[1][2]
  • Conservative management with observation and close imaging follow-up is recommended among certain patients with
    small sized asymptomatic meningioma.[1][2]
  • Meningioma among patients younger than 60 years of age are more likely to grow in size on repeated imaging studies; thus
    conservative management is not recommended among such patients.[1][2]
  • Conservative management is not recommended among symptomatic meningioma patients.[1][2]


Radiation therapy


Chemotherapy

  • Chemotherapeutic agents are generally not effective against meningioma.[2]
  • Antiprogestin agents have been used to treat meningioma but with variable results.[2]
  • Recent evidence that hydroxyurea has the capacity to shrink unresectable or recurrent meningiomas is being further evaluated.[2]

References

  1. 1.0 1.1 1.2 1.3 1.4 Herscovici Z, Rappaport Z, Sulkes J, Danaila L, Rubin G (2004). "Natural history of conservatively treated meningiomas". Neurology. 63 (6): 1133–4. PMID 15452322.
  2. 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015
  3. 3.0 3.1 Maclean J, Fersht N, Short S (2014). "Controversies in radiotherapy for meningioma". Clin Oncol (R Coll Radiol). 26 (1): 51–64. doi:10.1016/j.clon.2013.10.001. PMID 24207113.
  4. 4.0 4.1 Ding D, Starke RM, Hantzmon J, Yen CP, Williams BJ, Sheehan JP (2013). "The role of radiosurgery in the management of WHO Grade 2 and 3 intracranial meningiomas". Neurosurg Focus. 35 (6): E16. doi:10.3171/2013.9.FOCUS13364. PMID 24289124.


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