Recent advances in the management of atypical meningiomas - 29/06/16

Doi : 10.1016/j.neuchi.2016.02.003

M. Messerer ^a,^⁎ , B. Richoz ^b, G. Cossu ^b, F. Dhermain ^c, A.F. Hottinger ^d, F. Parker ^a, M. Levivier ^b, R.T. Daniel ^b
^a Department of neurosurgery, faculty of medicine - Paris Sud, Kremlin-Bicêtre university hospital, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
^b Department of clinical neurosciences, service of neurosurgery, faculty of medicine and biology of Lausanne, Lausanne university hospital, 46, rue du Bugnon, 1011 Lausanne, Switzerland
^c Department of radiation oncology, institut Gustave-Roussy university hospital, 114, rue Edouard-Vaillant, 94805 Villejuif, France
^d Neuro-oncology unit, department of clinical neurosciences & oncology, Lausanne university hospital, faculty of medicine and biology of Lausanne, 46, rue du Bugnon, 1011 Lausanne, Switzerland

^⁎Corresponding author. Department of neurosurgery, centre hospitalier universitaire Vaudois, 1011 Lausanne, Switzerland.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 29 June 2016
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Abstract

Based on the 2007 WHO classification, the proportion of atypical meningiomas has steeply increased. Complete resection is usually considered curative, however, the recurrence rate remains high. The treatment of more aggressive meningiomas remains problematic. We performed a literature review via the PubMed database with specific attention to radiological, pathological, genetic and molecular aspects particular to WHO grade II meningiomas and current therapeutic strategies. We also reviewed the role of surgery and summarized the results of the principal studies dealing with adjuvant strategies based on the most recent evidence. Adjuvant radiotherapy, administered as stereotactic radiosurgery or conventional external beam irradiation, should be strongly considered in selected cases. Limited data exist regarding the role of hormonal treatment or chemotherapy as adjunct therapy. A target therapy modulating the altered molecular balance may be the key to revolutionize the prognosis of these patients.

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Keywords : Atypical meningioma, WHO grade II meningioma, Management, Genetics, Molecular biology, Radiology, Surgery, Adjuvant radiotherapy, Stereotactic radiosurgery, Conventional external beam radiotherapy