Meningioma

Meningioma is the most common primary intracranial tumor. Treatment alternatives for meningioma include surgery, radiotherapy, stereotactic radiosurgery (SRS), or a combination of these depending on patient- and tumor-specific factors. Meningioma outcomes are dictated by (1) extent of resection and other clinical and histopathologic features, including meningioma grade and setting, with outcomes from primary meningiomas being superior to outcomes from re-treatment of recurrent meningiomas; and by (2) patient age and medical comorbidities, much like meningioma size and location, may influence operative or other treatment decisions. For small meningiomas that are not immediately adjacent to critical structures such as the optic apparatus, single-fraction or fractionated SRS are safe and effective treatment alternatives to resection. In the adjuvant setting, SRS may also be used for incompletely resected meningiomas. Here, we provide a comprehensive review of the use of SRS for meningioma, with an emphasis on practical day-to-day considerations, guidelines, and applications for clinicians.