Meningioma interventions: Difference between revisions
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* In situations where complete resection (with low morbidity) can be achieved, and/or to decompress tumors associated with pressure symptoms, surgery is highly appropriate.<ref name="pmid30782319">{{cite journal| author=Smee R, Williams J, Kotevski D, Schneider M| title=Radiotherapy as a means of treating meningiomas. | journal=J Clin Neurosci | year= 2019 | volume= 61 | issue= | pages= 210-218 | pmid=30782319 | doi=10.1016/j.jocn.2018.10.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30782319 }} </ref> | * In situations where complete resection (with low morbidity) can be achieved, and/or to decompress tumors associated with pressure symptoms, surgery is highly appropriate.<ref name="pmid30782319">{{cite journal| author=Smee R, Williams J, Kotevski D, Schneider M| title=Radiotherapy as a means of treating meningiomas. | journal=J Clin Neurosci | year= 2019 | volume= 61 | issue= | pages= 210-218 | pmid=30782319 | doi=10.1016/j.jocn.2018.10.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30782319 }} </ref> | ||
* There could be a 20.5% risk for stroke associated with conventionally fractionated radiotherapy (radiation-based), with the average stroke developing about 5.6 years after the treatment.<ref name="pmid30775077">{{cite journal| author=McClelland Iii S, Mitin T, Kubicky CD, Jaboin JJ| title=Long-term stroke risk in meningioma patients treated with conventionally fractionated photon-based radiation therapy. | journal=J Radiosurg SBRT | year= 2019 | volume= 6 | issue= 1 | pages= 77-79 | pmid=30775077 | doi= | pmc=6355449 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30775077 }} </ref> | * There could be a 20.5% risk for stroke associated with conventionally fractionated radiotherapy (radiation-based), with the average stroke developing about 5.6 years after the treatment.<ref name="pmid30775077">{{cite journal| author=McClelland Iii S, Mitin T, Kubicky CD, Jaboin JJ| title=Long-term stroke risk in meningioma patients treated with conventionally fractionated photon-based radiation therapy. | journal=J Radiosurg SBRT | year= 2019 | volume= 6 | issue= 1 | pages= 77-79 | pmid=30775077 | doi= | pmc=6355449 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30775077 }} </ref> | ||
* Adjuvant radiotherapy can improve survival in patients that present with atypical meningioma with brain invasion.<ref name="pmid17766430">{{cite journal| author=Yang SY, Park CK, Park SH, Kim DG, Chung YS, Jung HW| title=Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features. | journal=J Neurol Neurosurg Psychiatry | year= 2008 | volume= 79 | issue= 5 | pages= 574-80 | pmid=17766430 | doi=10.1136/jnnp.2007.121582 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17766430 }} </ref> | |||
==References== | ==References== | ||
Revision as of 14:59, 5 April 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];
Overview
There are no recommended therapeutic interventions for the management of [disease name].
OR
[Name of intervention] is not the first-line treatment option for patients with [disease name]. [Name of intervention] is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
OR
The mainstay of treatment for [disease name] is medical therapy/surgery. [Name of intervention] is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
OR
The feasibility of [name of intervention] depends on the stage of [disease or malignancy] at the time of diagnosis.
OR
[Name of intervention] is the mainstay of treatment for [disease or malignancy].
Indications
Observation/Expectant management
- In some cases, a meningioma can be found incidentally when doing a work-up for something else. Expectant management can be pursued in incidental meningiomas without tissue edemas, vascular compromise, or those only presenting with epileptic seizures that are easily controlled with anti-epileptic medications.[1]
Radiotherapy
- The decision to treat with either surgery or radiotherapy depends on patient factors and the anatomical location of the tumor.[2]
- For the treatment of smaller meningiomas, single fraction stereotactic radiosurgery may be used. Fractionated radiotherapy is used for larger volume tumors and/or those in contact with the optic chiasm/nerve.[2]
- It can lead to symptom improvement with about less than 5% of patients presenting with worsened neurological deficit.[2]
- In some cases, subtotal resection (a form of surgery) followed by radiotherapy is done. This provides only little advantage over treatment with radiotherapy alone.[2]
- In situations where complete resection (with low morbidity) can be achieved, and/or to decompress tumors associated with pressure symptoms, surgery is highly appropriate.[2]
- There could be a 20.5% risk for stroke associated with conventionally fractionated radiotherapy (radiation-based), with the average stroke developing about 5.6 years after the treatment.[3]
- Adjuvant radiotherapy can improve survival in patients that present with atypical meningioma with brain invasion.[4]
References
- ↑ Sumkovski R, Micunovic M, Kocevski I, Ilievski B, Petrov I (2019). "Surgical Treatment of Meningiomas - Outcome Associated With Type of Resection, Recurrence, Karnofsky Performance Score, Mitotic Count". Open Access Maced J Med Sci. 7 (1): 56–64. doi:10.3889/oamjms.2018.503. PMC 6352459. PMID 30740161.
- ↑ 2.0 2.1 2.2 2.3 2.4 Smee R, Williams J, Kotevski D, Schneider M (2019). "Radiotherapy as a means of treating meningiomas". J Clin Neurosci. 61: 210–218. doi:10.1016/j.jocn.2018.10.006. PMID 30782319.
- ↑ McClelland Iii S, Mitin T, Kubicky CD, Jaboin JJ (2019). "Long-term stroke risk in meningioma patients treated with conventionally fractionated photon-based radiation therapy". J Radiosurg SBRT. 6 (1): 77–79. PMC 6355449. PMID 30775077.
- ↑ Yang SY, Park CK, Park SH, Kim DG, Chung YS, Jung HW (2008). "Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features". J Neurol Neurosurg Psychiatry. 79 (5): 574–80. doi:10.1136/jnnp.2007.121582. PMID 17766430.