title: Fractionated radiotherapy and radiosurgery of intracranial meningiomas.
abstract: This review focuses on the role of radiosurgery and fractionated radiotherapy in the management of intracranial meningiomas, which are the most common benign intracranial tumors. Whenever feasible, surgery remains a cornerstone of treatment in effective health care treatment where modern radiotherapy plays an important role. Irradiation can be proposed as first-line treatment, as adjuvant treatment, or as a second-line treatment after recurrence. Stereotactic radiosurgery consists of delivering, a high-dose of radiation with high precision, to the tumor in a single-fraction with a minimal exposure of surrounding healthy tissue. Stereotactic radiosurgery, especially with the gamma knife technique, has reached a high level of success for the treatment of intracranial meningiomas with excellent local control and low morbidity. However, stereotactic radiosurgery is limited by tumor size,<3-4cm, and location, i.e. reasonable distance from the organs at risk. Fractionated radiation therapy is an interesting alternative (5 to 6weeks treatment time) for large inoperable tumors. The results of fractionated radiation therapy seem encouraging as regards both local control and morbidity although long-term prospective studies are still needed.
authors.affiliation: Centre Jean-Perrin, Département de Radiothérapie, 63000 Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Biau
authors.affiliation: CHU de Clermont-Ferrand, Hôpital Gabriel-Montpied, Service de Neurochirurgie, 63003 Clermont-Ferrand, France.
authors.forename: T
authors.initials: T
authors.lastname: Khalil
authors.affiliation: Centre Jean-Perrin, Département de Radiothérapie, 63000 Clermont-Ferrand, France.
authors.forename: P
authors.initials: P
authors.lastname: Verrelle
authors.affiliation: CHU de Clermont-Ferrand, Hôpital Gabriel-Montpied, Service de Neurochirurgie, 63003 Clermont-Ferrand, France. Electronic address: jjlemaire@chu-clermontferrand.fr.
authors.forename: J-J
authors.initials: JJ
authors.lastname: Lemaire
mesh_terms: D001932:Brain Neoplasms / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D006801:Humans; D008577:Meningeal Neoplasms / Q000532:radiotherapy*; D008579:Meningioma / Q000532:radiotherapy*; D016634:Radiosurgery
keywords: Meningioma; Méningiome; Radiochirurgie; Radiosurgery; Radiotherapy; Radiothérapie