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However, complete resection is frequently limited by proximity to critical structures, necessitating adjuvant or definitive radiotherapy. Proton therapy offers dosimetric advantages over photon-based radiotherapy, particularly in sparing adjacent normal tissues. This study aims to systematically evaluate the effectiveness and safety of proton therapy for intracranial meningiomas across tumor grades and clinical scenarios.\u00a0A systematic review and meta-analysis was conducted according to PRISMA 2020 guidelines using PubMed, EMBASE, Scopus, Web of Science, and Cochrane from inception to November 10, 2025. Studies were eligible if they reported clinical outcomes of proton therapy in \u2265\u200910 adult meningioma patients. Data extraction and risk-of-bias assessment were performed independently by two reviewers. Pooled complication rates and survival outcomes were calculated using random-effects models.\u00a0Nineteen studies involving 1,431 patients were included. WHO Grade I tumors comprised 70.6% of cases; Grades II\/III made up 25.2% and 4.2%, respectively. The most common proton dose regimens ranged from 13 to 70.2 Gy (RBE). The pooled complication rate was 16% (95% CI 5\u201327;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001; I\u00b2 = 98.5%). Nine studies reported a statistically significant 5-year overall-survival proportion of 91% (95% CI 88\u201394;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001; I\u00b2 = 49.3%). Radiologic local control averaged 71% (95% CI 50\u201386; I\u00b2 = 88.2%).\u00a0Proton therapy provides effective tumor control with acceptable toxicity, especially for low-grade or anatomically complex meningiomas. It is a valuable option for select patients, though further prospective studies are needed to optimize dosing and assess long-term outcomes.\n                  <\/jats:p>","DOI":"10.1007\/s10143-026-04319-5","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T01:49:34Z","timestamp":1778291374000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness and safety of proton therapy in intracranial meningioma treatment: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"49","author":[{"given":"Jeremiah Hillkiah","family":"Wijaya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelrahman Ramadan","family":"Elashry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarmad","family":"Javaid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohga","family":"Yasser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bismon","family":"Jibu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharath","family":"Narayanan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela A.","family":"Perez-Chadid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aafreen","family":"Azmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"Avila-Madrigal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth E.","family":"Ginalis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Nanda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"key":"4319_CR1","volume-title":"Meningioma","author":"AA Alruwaili","year":"2025","unstructured":"Alruwaili AA, De Jesus O (2025) Meningioma. 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His affiliation also needs to be corrected to <sup>2<\/sup>College of Medicine, University of Sharjah, Sharjah, UAE.","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The original article online has been corrected.","order":9,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2026","order":10,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":11,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":12,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s10143-026-04339-1","URL":"https:\/\/doi.org\/10.1007\/s10143-026-04339-1","order":13,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"This article is a systematic review and meta-analysis of previously published studies and does not involve any intervention on human participants by the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human ethics and consent to participate declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"399"}}