Meningioma

Total excision is an appropriate treatment option for patients with benign meningiomas that are resectable with minimal morbidity. It is particularly appropriate for patients with significant mass effect causing symptoms. Fractionated conformal radiotherapy is an appropriate primary treatment option for patients with benign meningiomas of all sizes and all sites. It is particularly appropriate and preferred for optic nerve sheath meningiomas, for which there are few alternatives. Planned subtotal resection is appropriate if decompression is expected to relieve acute symptoms. After subtotal resection, it is appropriate to offer single-fraction radiosurgery or multifraction radiotherapy, depending on the size, location, and extent of residual tumor, so as to achieve progression-free survival and cause-specific survival rates comparable to those of other approaches.