{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:09:09Z","timestamp":1789578549115,"version":"build-2803163510"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T00:00:00Z","timestamp":1727827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T00:00:00Z","timestamp":1727827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiat Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Anaplastic meningiomas, categorized as WHO grade 3 tumors, are rare and highly aggressive, accounting for 1-2% of all meningioma cases. Despite aggressive treatment, including surgery and Radiation, they exhibit a high recurrence rate and poor survival outcomes. The aggressive histopathological features emphasize the urgent need for effective management strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective multi-institutional analysis was conducted on patients with recurrent anaplastic meningioma who underwent re-irradiation between 2017 and 2023. Clinical, dosimetric, and outcome data were collected and analyzed, focusing on local control, progression free survival and treatment-related adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-four cases were analyzed, with a median follow-up 11 months after re-irradiation. Progression-free survival at 12 months was 61.9%, with higher doses correlating with better outcomes. Concomitant Bevacizumab improves progression-free survival and reduces the risk of radiation necrosis. CDKN2A homozygote deletion correlated with a higher risk of local failure. Symptomatic radiation necrosis occurred in 20.5% of cases, but its incidence was lower with concomitant Bevacizumab treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Re-irradiation presents a viable option for recurrent anaplastic meningioma despite the associated risk of radiation necrosis. Higher doses with concomitant Bevacizumab improve clinical outcomes and reduce toxicity. Individualized treatment approaches are necessary, emphasizing the importance of further research to refine management strategies for this challenging disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13014-024-02486-7","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T16:38:34Z","timestamp":1727887114000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Re-irradiation of anaplastic meningioma: higher dose and concomitant Bevacizumab may improve progression-free survival"],"prefix":"10.1186","volume":"19","author":[{"given":"Ory","family":"Haisraely","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Taliansky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maayan","family":"Sivan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaacov","family":"Lawerence","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,2]]},"reference":[{"issue":"6","key":"2486_CR1","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1007\/s00401-016-1545-1","volume":"131","author":"E D Louis","year":"2016","unstructured":"D Louis E, et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol. 2016;131(6):803\u201320.","journal-title":"Acta Neuropathol"},{"issue":"4","key":"2486_CR2","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1016\/j.ijrobp.2019.11.028","volume":"106","author":"CL Rogers","year":"2020","unstructured":"Rogers CL, et al. High-risk Meningioma: initial outcomes from NRG Oncology\/RTOG 0539. Int J Radiat Oncol Biol Phyc. 2020;106(4):790\u20139.","journal-title":"Int J Radiat Oncol Biol Phyc"},{"issue":"8","key":"2486_CR3","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1093\/neuonc\/noab106","volume":"23","author":"D Louis","year":"2021","unstructured":"Louis D, et al. The 2021 WHO classification of tumors of the Central Nervous System: a summary. Neuro Oncol. 2021;23(8):1231\u201351.","journal-title":"Neuro Oncol"},{"issue":"4","key":"2486_CR4","doi-asserted-by":"publisher","first-page":"244","DOI":"10.14791\/btrt.2022.0030","volume":"10","author":"DO Seo","year":"2022","unstructured":"Seo DO, et al. Anaplastic meningioma: clinical characteristics, prognostic factors and survival outcome. Brain Tumor Res Treat. 2022;10(4):244\u201354.","journal-title":"Brain Tumor Res Treat"},{"key":"2486_CR5","doi-asserted-by":"crossref","unstructured":"P wen et al, RANO 2.0: update to the Response Assessment in Neuro-Oncology Criteria for High- and low-Grade gliomas in adults. J Clin Oncol. Sep 2023;41(33).","DOI":"10.1093\/neuonc\/noad189"},{"key":"2486_CR6","unstructured":"Bi W et al. Oncologic and functional outcomes and complications after reoperation for recurrent skull base meningiomas. J Neurosurg 2019;130(1):25\u201334."},{"key":"2486_CR7","first-page":"378","volume":"107","author":"M Karsy","year":"2017","unstructured":"Karsy M, et al. Second surgery for recurrent meningiomas and Outcome predictors. World Neurosurg. 2017;107:378\u201387.","journal-title":"World Neurosurg"},{"key":"2486_CR8","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1186\/s40478-023-01690-y","volume":"11","author":"J Wach","year":"2023","unstructured":"Wach J, et al, et al. CDKN2A\/B deletions are strongly associated with meningioma progression: a meta-analysis of individual patient data. Acta Neuropathol Commun. 2023;11:189.","journal-title":"Acta Neuropathol Commun"},{"issue":"2","key":"2486_CR9","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1007\/s11060-022-04107-3","volume":"161","author":"A Pontorerio","year":"2023","unstructured":"Pontorerio A, et al. The Combo radiotherapy treatment for high-risk grade 2 meningiomas: dose escalation and initial safety and efficacy analysis. J Neurooncol. 2023;161(2):203\u201314.","journal-title":"J Neurooncol"},{"issue":"16","key":"2486_CR10","doi-asserted-by":"publisher","first-page":"e29166","DOI":"10.1097\/MD.0000000000029166","volume":"101","author":"W Zheng","year":"2022","unstructured":"Zheng W, et al. Intensity-modulated radiotherapy with more than 60 gy improved the survival of inoperable patients with locally advanced esophageal squamous cell carcinoma: a population-based real-world study. Med (Baltimore). 2022;101(16):e29166.","journal-title":"Med (Baltimore)."},{"key":"2486_CR11","doi-asserted-by":"publisher","first-page":"607","DOI":"10.7785\/tcrt.2012.500267","volume":"11","author":"AW Chan","year":"2012","unstructured":"Chan AW, et al. Dose escalation with proton radiation therapy for high-grade meningiomas. Technol Cancer Res Treat. 2012;11:607\u201314. https:\/\/doi.org\/10.7785\/tcrt.2012.500267.","journal-title":"Technol Cancer Res Treat"},{"issue":"6","key":"2486_CR12","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1200\/JCO.22.00164","volume":"41","author":"CL Tesien","year":"2023","unstructured":"Tesien CL, NRG Oncology\/RTOG1205, et al. A randomized phase II trial of concurrent Bevacizumab and Reirradiation Versus Bevacizumab alone as treatment for recurrent glioblastoma. J Clin Oncol. 2023;41(6):1285\u201395.","journal-title":"J Clin Oncol"},{"key":"2486_CR13","doi-asserted-by":"publisher","first-page":"593449","DOI":"10.3389\/fonc.2021.593449","volume":"11","author":"G Liao","year":"2021","unstructured":"Liao G, et al. Bevacizumab Treatment of Radiation-Induced Brain necrosis: a systematic review. 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