Meningioma medical therapy
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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 suggests that both external beam radiotherapy and radiosurgery play an important role in the management of grade II and III meningiomas.[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.
- Meningiomas are more likely to grow in size on repeated imaging studies among patients younger than 60 years of age; thus conservative management is not recommended in these patients.
- Conservative management is not recommended among symptomatic meningioma patients.
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.[3][4]
Chemotherapy
- Chemotherapeutic agents are generally not effective against meningioma.[2]
- Antiprogestin agents have been used to treat meningioma but with variable results.
- Recent evidence that hydroxyurea has the capacity to shrink unresectable or recurrent meningiomas is being further evaluated.
References
- ↑ 1.0 1.1 Herscovici Z, Rappaport Z, Sulkes J, Danaila L, Rubin G (2004). "Natural history of conservatively treated meningiomas". Neurology. 63 (6): 1133–4. PMID 15452322.
- ↑ 2.0 2.1 2.2 2.3 2.4 Meningioma. Wikipedia(2015) https://en.wikipedia.org/wiki/Meningioma Accessed on September, 25 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 2 and 3 intracranial meningiomas". Neurosurg Focus. 35 (6): E16. doi:10.3171/2013.9.FOCUS13364. PMID 24289124.