Meningioma medical therapy: Difference between revisions
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==Overview== | ==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]].<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> Current data suggest that both [[external beam radiotherapy]] and [[radiosurgery]] play an important role in the management of grade II and III meningiomas.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref><ref name="pmid24207113">{{cite journal| author=Maclean J, Fersht N, Short S| title=Controversies in radiotherapy for meningioma. | journal=Clin Oncol (R Coll Radiol) | year= 2014 | volume= 26 | issue= 1 | pages= 51-64 | pmid=24207113 | doi=10.1016/j.clon.2013.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24207113 }} </ref><ref name="pmid24289124">{{cite journal| author=Ding D, Starke RM, Hantzmon J, Yen CP, Williams BJ, Sheehan JP| title=The role of radiosurgery in the management of WHO Grade II and III intracranial meningiomas. | journal=Neurosurg Focus | year= 2013 | volume= 35 | issue= 6 | pages= E16 | pmid=24289124 | doi=10.3171/2013.9.FOCUS13364 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24289124 }} </ref> [[Chemotherapeutic agent]]s are not effective against meningioma.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref> | |||
==Medical Therapy== | ==Medical Therapy== | ||
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'''Radiation therapy''' | '''Radiation therapy''' | ||
* The predominant therapy for meningioma is surgical resection. Adjunctive [[radiation therapy]] may be required among certain patients. | * The predominant therapy for meningioma is surgical resection. Adjunctive [[radiation therapy]] may be required among certain patients.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref> | ||
* Current data suggest that both [[external beam radiotherapy]] and [[radiosurgery]] play an important role in the management of grade II<br> and III meningiomas.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref><ref name="pmid24207113">{{cite journal| author=Maclean J, Fersht N, Short S| title=Controversies in radiotherapy for meningioma. | journal=Clin Oncol (R Coll Radiol) | year= 2014 | volume= 26 | issue= 1 | pages= 51-64 | pmid=24207113 | doi=10.1016/j.clon.2013.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24207113 }} </ref><ref name="pmid24289124">{{cite journal| author=Ding D, Starke RM, Hantzmon J, Yen CP, Williams BJ, Sheehan JP| title=The role of radiosurgery in the management of WHO Grade II and III intracranial meningiomas. | journal=Neurosurg Focus | year= 2013 | volume= 35 | issue= 6 | pages= E16 | pmid=24289124 | doi=10.3171/2013.9.FOCUS13364 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24289124 }} </ref> | * Current data suggest that both [[external beam radiotherapy]] and [[radiosurgery]] play an important role in the management of grade II<br> and III meningiomas.<ref name="W">Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25th 2015</ref><ref name="pmid24207113">{{cite journal| author=Maclean J, Fersht N, Short S| title=Controversies in radiotherapy for meningioma. | journal=Clin Oncol (R Coll Radiol) | year= 2014 | volume= 26 | issue= 1 | pages= 51-64 | pmid=24207113 | doi=10.1016/j.clon.2013.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24207113 }} </ref><ref name="pmid24289124">{{cite journal| author=Ding D, Starke RM, Hantzmon J, Yen CP, Williams BJ, Sheehan JP| title=The role of radiosurgery in the management of WHO Grade II and III intracranial meningiomas. | journal=Neurosurg Focus | year= 2013 | volume= 35 | issue= 6 | pages= E16 | pmid=24289124 | doi=10.3171/2013.9.FOCUS13364 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24289124 }} </ref> | ||
Revision as of 17:17, 27 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 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 meningioma patients who are already symptomatic.[1][2]
Radiation therapy
- The predominant therapy for meningioma is surgical resection. Adjunctive radiation therapy may be required among certain patients.[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]
Chemotherapy
- Chemotherapeutic agents are not effective against meningioma.[2]
- Antiprogestin agents have been used, but with variable results.[2]
- Recent evidence that hydroxyurea has the capacity to shrink unresectable or recurrent meningiomas is being further evaluated.[2]
References
- ↑ 1.0 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.
- ↑ 2.00 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
- ↑ 3.0 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.
- ↑ 4.0 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 II and III intracranial meningiomas". Neurosurg Focus. 35 (6): E16. doi:10.3171/2013.9.FOCUS13364. PMID 24289124.