Radiation has been used to treat meningiomas since the mid-1970s. Traditionally, radiation was reserved for patients unfit for major surgery or those with surgically inaccessible tumors. With an increased quantity and quality of imaging, and an aging population, there has been a rise in incidentally diagnosed meningiomas with smaller tumors at diagnosis time. Deciding if, how, and when to intervene must be determined on a case-by-case basis. Anatomical location and adjacent vital structures are crucial for decision-making. Prior review articles have detailed outcomes of radiosurgery in broad anatomical regions such as the skull base, but a recent deluge of research on increasingly specific anatomical subregions deserves attention. This narrative review synthesizes information regarding specific anatomical subregions, including anatomical challenges, radiosurgical outcomes, and unique considerations. Via MEDLINE and ascendancy search, we utilized evidence available for each anatomical region and herein discuss details of published research and explore future directions. Meningioma management remains individualized based on patient comorbidities, tumor location/characteristics, symptomatic burden, and patient age. In addition to stereotactic radiosurgery’s established role for surgically inaccessible, recurrent, and high-grade meningiomas, its use as upfront management for small asymptomatic meningiomas is increasingly investigated. For all subregions reported, radiosurgical intervention resulted in high tumor control rates and acceptably low adverse radiation events.
自20世纪70年代中期起，放射治疗已被应用于脑膜瘤的治疗。传统上，放射治疗主要适用于无法承受大型手术或肿瘤手术难以切除的患者。随着影像学检查数量与质量的提升，以及人口老龄化趋势，偶然诊断出的脑膜瘤数量有所增加，且诊断时肿瘤体积往往较小。是否干预、如何干预以及何时干预，必须根据具体病例逐一决定。解剖位置及邻近重要结构是决策的关键因素。既往综述文章已详细阐述了放射外科在广泛解剖区域（如颅底）的治疗效果，但近期针对更具体解剖亚区域的大量研究值得关注。本文通过整合特定解剖亚区域的相关信息，包括解剖学挑战、放射外科治疗效果及特殊考量因素，对现有研究进行系统性综述。通过MEDLINE及引文追溯检索，我们收集了各解剖区域的相关证据，详细讨论了已发表研究的具体内容，并探讨了未来研究方向。脑膜瘤的治疗仍需根据患者合并症、肿瘤位置/特征、症状负担及患者年龄进行个体化决策。除了立体定向放射外科在手术难以切除、复发及高级别脑膜瘤治疗中的既定作用外，其作为小型无症状脑膜瘤初始治疗手段的研究也日益增多。在所有已报道的解剖亚区域中，放射外科干预均实现了较高的肿瘤控制率及可接受的低不良放射事件发生率。
肿瘤(癌症)患者之家