Treatment of High-grade Meningiomas

Abstract

  High-grade meningioma (WHO grades 2 and 3) treatment is challenging due to the tendency of the tumor to recur locally. Surgical removal, the primary treatment modality, has a limited success rate. Radiation therapy, particularly fractionated external-beam X-ray irradiation, has shown efficacy in controlling these tumors when performed early after resection. Stereotactic irradiation and intensity-modulated radiotherapy are used to treat residual and recurrent tumors. Trials using chemotherapeutics against high-grade meningiomas have yielded 6-month progression-free rates (PFS-6) of up to 26%. Boron neutron capture therapy (BNCT) has shown promising results with a reported PFS of 13.7 months, generating significant interest domestically and internationally in its potential for treating high-grade meningiomas.