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Median age was 61 years (range, 15\u201388). Tumor location was non-skull base in 69.1% and skull base in 30.9%. All patients underwent fractionated radiotherapy with a median dose of 59.4\u00a0Gy (range, 34\u201368). Follow-up included MRI and assessment of local control (LC), progression-free survival (PFS), overall survival (OS), and toxicity (CTCAE v5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At last follow-up, 94 patients (96.9%) were alive. Median OS was not reached, with survival rates of 100% at 2 and 5 years and 99% at 8 years. Median PFS was 32.0 months, with 2- and 5-year rates of 88.7% and 66.0%. Median LC was 33.0 months, with 2- and 5-year rates of 91.8% and 72.2%. Disease progression occurred in 40 patients (41.2%), including 30 in-field and 22 outside the irradiated volume. Early toxicities were mainly Grade I\u2013II, most commonly alopecia, fatigue, and headache. Late toxicities were less frequent, including headache, seizures, vertigo, and radiation-induced cerebral contrast enhancement (RICE). Severe late toxicity (Grade III) was rare (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093). Particle therapy was associated with lower rates of vertigo and headache.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High-precision photon and particle radiotherapy achieved effective long-term control with favorable safety in high-grade meningiomas. Most adverse effects were mild and manageable, supporting the role of particle therapy in reducing selected late toxicities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11060-025-05255-y","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T14:04:39Z","timestamp":1761314679000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcomes and toxicity of radiotherapy for WHO Grade II and III meningiomas: a retrospective analysis of 98 patients"],"prefix":"10.1007","volume":"176","author":[{"given":"Kerem Tuna","family":"Tas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Finja Svende","family":"H\u00f6ft","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Agolli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tasneim Abdelrahman","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatima Frosan","family":"Sheikhzadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Lishewski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Schymalla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klemens","family":"Zink","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilke","family":"Vorwerk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Semi B.","family":"Harrabi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Habermehl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Adeberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Gawish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"issue":"3","key":"5255_CR1","doi-asserted-by":"publisher","first-page":"319","DOI":"10.3390\/biomedicines9030319","volume":"9","author":"C Ogasawara","year":"2021","unstructured":"Ogasawara C, Philbrick BD, Adamson DC, Meningioma (2021) A review of Epidemiology, Pathology, Diagnosis, Treatment, and future directions. 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