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Long-Term Outcomes and Symptom Response Following Hypofractionated Stereotactic Radiotherapy for Intracranial Meningioma
Journal article   Open access   Peer reviewed

Long-Term Outcomes and Symptom Response Following Hypofractionated Stereotactic Radiotherapy for Intracranial Meningioma

Ryan Shah, Nilanjan Haldar, Shray Jain, Lauren Holt, Sophia Shah, Hamail Iqbal, Anthony Y. Chen, Christopher J. Farrell, Debanjan Haldar, James J. Evans, …
World neurosurgery, v 211, 125045
01 Jul 2026
DOI: https://doi.org/10.1016/j.wneu.2026.125045
PMID: 42128342
Featured in Collection :   Drexel's Newest Publications
url
https://doi.org/10.1016/j.wneu.2026.125045View
Published, Version of Record (VoR) Open CC BY V4.0

Abstract

Hypofractionation Meningioma Radiotherapy
Various radiation dosing regimens exist due to tumor size, location, and patient preference. This study evaluated the long-term outcomes of patients with benign meningiomas treated with hypofractionated stereotactic radiotherapy (SRT)at our institution. This is a retrospective review of all patients diagnosed with meningioma at our institution who received hypofractionated SRT (5 fractions). Clinical data, including tumor location, size, prior treatments, demographics, radiation dosimetric information, tumor response, and survival were collected. Kaplan-Meier curves were used to assess local control (LC). Acute and late toxicities were evaluated. Patients were included for analysis if they had at least one post-treatment magnetic resonance imaging following therapy. One hundred-eight patients with benign meningiomas treated between 2013 and 2022 were identified, with 92 included for analysis (n = 16 excluded due to lack of follow-up). With median follow-up of 28 months, the 1-year, 3-year, and 5-year LC rates were 98%, 93%, and 87%, respectively. Fifty-three (58%) patients had partial improvement or resolution of presenting symptoms after completing radiation treatment. When conducting a subgroup analysis excluding patients previously treated with radiation, LC improved to 99%, 97%, and 94% at 1, 3, and 5 years, respectively. Seventeen patients (18%) had G1 or G2 toxicities, with 3 of them experiencing G2 radionecrosis. Tumors were categorized by size and Chi-squared analysis showed no difference in the rate of failure (χ2 = 0.6, P = 0.73). The SRT regimen of 25 Gy in 5 fractions effectively achieves LC and safety in benign meningiomas. These findings highlight the need for further clinical studies to better understand World Health Organization grade 1 meningiomas.

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