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1. Microsurgical neurosurgical resection
Surgery is the preferred curative approach for symptomatic tumors, aiming to achieve gross total resection of the tumor and involved dura while preserving neurological function.
2. Minimally invasive surgery and intraoperative adjunct techniques
Neuronavigation, intraoperative MRI, and electrophysiological monitoring enable precise localization, protection of eloquent areas, and improved surgical safety and extent of resection.
3. Stereotactic radiosurgery
Gamma Knife and CyberKnife are suitable for small-to-medium tumors or postoperative residual disease. A single high-precision treatment can effectively control tumor growth.
4. Fractionated stereotactic radiotherapy
For larger tumors, irregularly shaped lesions, or those adjacent to critical neural structures, fractionated treatment balances local control with tissue protection.
5. Conventional external beam radiotherapy
Used as adjuvant therapy after surgery for WHO grade II–III disease or for unresectable tumors. Intensity-modulated radiotherapy enables conformal targeting and reduces recurrence risk.
6. Molecular targeted therapy and systemic drug therapy
Conventional chemotherapy is ineffective. Targeted agents and cell-cycle inhibitors are under clinical investigation and may offer options for refractory cases.
7. Hormonal therapy and supportive care
Antiprogestin therapy has limited efficacy. Supportive measures include mannitol or corticosteroids for edema control and standardized antiseizure medication when indicated.
8. Individualized decision-making and active surveillance
Strategies are highly individualized. Asymptomatic small tumors may be monitored with active surveillance to avoid overtreatment, incorporating patient preferences.
9. Skull base surgery for complex locations
Skull base meningiomas are deep-seated and high-risk, requiring experienced teams and specialized approaches to maximize the chance of complete resection.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that although most meningiomas are benign, mass effect can cause seizures and neurological deficits. “Individualized precision management” is essential: early diagnosis is a prerequisite for functional preservation, and MDT-based collaboration supports careful selection among surgery, radiotherapy, or surveillance. Molecular pathology can guide longitudinal management to preserve quality of life.
1. Microsurgical neurosurgical resection
Surgery is the preferred curative approach for symptomatic tumors, aiming to achieve gross total resection of the tumor and involved dura while preserving neurological function.
2. Minimally invasive surgery and intraoperative adjunct techniques
Neuronavigation, intraoperative MRI, and electrophysiological monitoring enable precise localization, protection of eloquent areas, and improved surgical safety and extent of resection.
3. Stereotactic radiosurgery
Gamma Knife and CyberKnife are suitable for small-to-medium tumors or postoperative residual disease. A single high-precision treatment can effectively control tumor growth.
4. Fractionated stereotactic radiotherapy
For larger tumors, irregularly shaped lesions, or those adjacent to critical neural structures, fractionated treatment balances local control with tissue protection.
5. Conventional external beam radiotherapy
Used as adjuvant therapy after surgery for WHO grade II–III disease or for unresectable tumors. Intensity-modulated radiotherapy enables conformal targeting and reduces recurrence risk.
6. Molecular targeted therapy and systemic drug therapy
Conventional chemotherapy is ineffective. Targeted agents and cell-cycle inhibitors are under clinical investigation and may offer options for refractory cases.
7. Hormonal therapy and supportive care
Antiprogestin therapy has limited efficacy. Supportive measures include mannitol or corticosteroids for edema control and standardized antiseizure medication when indicated.
8. Individualized decision-making and active surveillance
Strategies are highly individualized. Asymptomatic small tumors may be monitored with active surveillance to avoid overtreatment, incorporating patient preferences.
9. Skull base surgery for complex locations
Skull base meningiomas are deep-seated and high-risk, requiring experienced teams and specialized approaches to maximize the chance of complete resection.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that although most meningiomas are benign, mass effect can cause seizures and neurological deficits. “Individualized precision management” is essential: early diagnosis is a prerequisite for functional preservation, and MDT-based collaboration supports careful selection among surgery, radiotherapy, or surveillance. Molecular pathology can guide longitudinal management to preserve quality of life.