The Role of Adjuvant Radiotherapy in the Treatment of Atypical Meningiomas: Implications in Strategic Management of Skull Base Meningiomas

• Main Authors: Gandhi, Jigar S., Mendelson, Zachary S., Liu, James K.
• Format: Conference Proceeding
• Language: English
• ISSN: 2193-6331; 2193-634X
• DOI: 10.1055/s-0035-1546701

Introduction: WHO grade II atypical meningiomas (AM) have a tendency to recur after resection. Adjuvant radiotherapy (RT) is often used to minimize the risk of recurrence. However, there is no definitive consensus as to the efficacy of RT, particularly after a gross total resection (GTR). Methods: A systematic review of published studies on AM resection was conducted from 1990 to 2014. Studies were identified using a PubMed search, as well as, from subsequent inspection of the citations found within each article. Articles reporting extent of resection, use of RT, and follow-up data were analyzed. Data were collected regarding extent of resection, use of RT, and rates of recurrence. Results: A meta-analysis was performed on a total of 1,001 patients from 13 studies. The recurrence rate after GTR alone (27.7%) was found to be similar to the recurrence rate after GTR + RT (20.5%; p  = 0.98). However, subtotal resection (STR) alone was found to have a significantly higher recurrence rate than STR + RT (71.6 vs. 41.8%; p  = 0.001). Overall, GTR was found to have a significantly lower recurrence rate than STR (26.9 vs. 51.3%; p