Grade I Meningioma
Grade II and III Meningioma and Hemangiopericytoma
Current Clinical Trials

Grade I Meningioma

World Health Organization (WHO) grade I meningiomas are usually curable when resectable. (Refer to the Meningeal Tumors section in the Classification section of this summary for more information.)

Standard treatment options:

1. Surgery.[1]
2. Surgery plus radiation therapy is used in selected cases, such as for patients with known or suspected residual disease or with recurrence after previous surgery.[2-4]
3. Radiation therapy for patients with unresectable tumors.[5]

The prognoses for patients with WHO grade II meningiomas (i.e., atypical, clear cell, and chordoid), WHO grade III meningiomas (i.e., anaplastic/malignant, rhabdoid, and papillary), and hemangiopericytomas are worse than for patients with low-grade meningiomas because complete resections are less common and the proliferative capacity is greater.[6,7] (Refer to the Meningeal Tumors section in the Classification section of this summary for more information.)

Standard treatment options:

• Surgery plus radiation therapy.

Treatment options under clinical evaluation:

• Patients with brain tumors that are either infrequently curable or unresectable should be considered candidates for clinical trials that evaluate interstitial brachytherapy, radiosensitizers, hyperthermia, or intraoperative radiation therapy in conjunction with external-beam radiation therapy to improve local control of the tumor. Such patients are also candidates for studies that evaluate new drugs and biological response modifiers following radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with adult meningeal tumor. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

General information about clinical trials is also available from the NCI Web site.

References

1. Black PM: Meningiomas. Neurosurgery 32 (4): 643-57, 1993.  [PUBMED Abstract]
   
   
2. Wara WM, Sheline GE, Newman H, et al.: Radiation therapy of meningiomas. Am J Roentgenol Radium Ther Nucl Med 123 (3): 453-8, 1975.  [PUBMED Abstract]
   
   
3. Barbaro NM, Gutin PH, Wilson CB, et al.: Radiation therapy in the treatment of partially resected meningiomas. Neurosurgery 20 (4): 525-8, 1987.  [PUBMED Abstract]
   
   
4. Taylor BW Jr, Marcus RB Jr, Friedman WA, et al.: The meningioma controversy: postoperative radiation therapy. Int J Radiat Oncol Biol Phys 15 (2): 299-304, 1988.  [PUBMED Abstract]
   
   
5. Debus J, Wuendrich M, Pirzkall A, et al.: High efficacy of fractionated stereotactic radiotherapy of large base-of-skull meningiomas: long-term results. J Clin Oncol 19 (15): 3547-53, 2001.  [PUBMED Abstract]
   
   
6. Alvarez F, Roda JM, Pérez Romero M, et al.: Malignant and atypical meningiomas: a reappraisal of clinical, histological, and computed tomographic features. Neurosurgery 20 (5): 688-94, 1987.  [PUBMED Abstract]
   
   
7. Perry A, Scheithauer BW, Stafford SL, et al.: "Malignancy" in meningiomas: a clinicopathologic study of 116 patients, with grading implications. Cancer 85 (9): 2046-56, 1999.  [PUBMED Abstract]
   
   

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