Meningiomas are the most common primary brain tumour, more common in women. Management is surgical if possible for grade 1 tumours, with RT (EBRT or SRS or SRT) being reserved for inoperable tumours such as those involving the cavenous sinus. In grade 2 tumours the role of adjuvant RT is controversial in those with radical resection- the ROAM study results should help to guide us when this study completes and reports- due to close in 2021. if partial resection in grade 2 then adjuvant RT is indicated, as it is in all grade 3 tumours. Meningiomas often cause considerable neurological complications, including neuro-cognitive impact, though this may improve post surgery. Management is often a balance between complications of treatment and complications of the tumour, with monitoring often employed to establish the growth rate and therefore the likelihood of increasing tumour effects within the patient's natural life expectancy.

Epidemiology and Aetiology

Epidemiology and Etiology Meningioma
Wiemels et al
J Neurooncology 2010

Review paper on the epidemiology and aetiology of meningioma, especially regarding female hormones and HRT use


EANO guidelines on the Investigation and Management of Mengingioma
Goldbanner et al
Lancet Oncology 2016

Good overview on how to investigate and treat. Use alongside the NICE guidance (on general page)

Optic nerve sheath meningioma review of radiotherapy outcomes
Jeremic et al
Cancer 2008

Useful overview of the results of treating optic nerve sheath meningioma with radiotherapy

ROAM study RTQA guidelines
ROAM study

Radiotherapy guidelines on how to contour adjuvant grade 2 meningioma tumour bed