{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:49:46Z","timestamp":1790700586718,"version":"4.1.0"},"reference-count":83,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004219","name":"Paul Scherrer Institut","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004219","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Meningeal tumors represent approximately 10\u201325% of primary brain tumors and occur usually in elderly female patients. Most meningiomas are benign (80\u201385%) and for symptomatic and\/or large tumors, surgery, with or without radiation therapy (RT), has been long established as an effective means of local tumor control. RT can be delivered to inoperable lesions or to those with non-benign histology and for Simpson I\u2013III and IV\u2013V resection. RT can be delivered with photons or particles (protons or carbon ions) in stereotactic or non-stereotactic conditions. Particle therapy delivered for these tumors uses the physical properties of charged carbon ions or protons to spare normal brain tissue (i.e. Bragg peak), with or without or a dose-escalation paradigm for non-benign lesions. PT can substantially decrease the dose delivered to the non-target brain tissues, including but not limited to the hippocampi, optic apparatus or cochlea. Only a limited number of meningioma patients have been treated with PT in the adjuvant or recurrent setting, as well as for inoperable lesions with pencil beam scanning and with protons only. Approximately 500 patients with image-defined or WHO grade I meningioma have been treated with protons. The reported outcome, usually 5-year local tumor control, ranges from 85 to 99% (median, 96%). For WHO grade II or III patients, the outcome of only 97 patients has been published, reporting a median tumor local control rate of 52% (range, 38\u201371.1). Only 24 recurring patients treated previously with photon radiotherapy and re-treated with PT were reported. The clinical outcome of these challenging patients seems interesting, provided that they presented initially with benign tumors, are not in the elderly category and have been treated previously with conventional radiation dose of photons. Overall, the number of meningioma patients treated or-re-irradiated with this treatment modality is small and the clinical evidence level is somewhat low (i.e. 3b\u20135). In this review, we detail the results of upfront PT delivered to patients with meningioma in the adjuvant setting and for inoperable tumors. The outcome of meningioma patients treated with this radiation modality for recurrent tumors, with or without previous RT, will also be reviewed.<\/jats:p>","DOI":"10.3389\/fonc.2020.558845","type":"journal-article","created":{"date-parts":[[2021,1,10]],"date-time":"2021-01-10T14:23:21Z","timestamp":1610288601000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":32,"title":["Proton Therapy for Intracranial Meningioma for the Treatment of Primary\/Recurrent Disease Including Re-Irradiation"],"prefix":"10.3389","volume":"10","author":[{"given":"Damien C.","family":"Weber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Bizzocchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Bolsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Jenkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-010-0386-3","article-title":"Epidemiology and etiology of meningioma","volume":"99","author":"Wiemels","year":"2010","journal-title":"J Neuro Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-016-1545-1","article-title":"The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary","volume":"131","author":"Louis","year":"2016","journal-title":"Acta Neuropathol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noz160","article-title":"A prognostic model to personalize monitoring regimes for patients with incidental asymptomatic meningiomas","volume":"22","author":"Islim","year":"2020","journal-title":"Neuro-oncology"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-019-03104-3","article-title":"Incidental intracranial meningiomas: a systematic review and meta-analysis of prognostic factors and outcomes","volume":"142","author":"Islim","year":"2019","journal-title":"J Neuro Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noy136","article-title":"Advances in multidisciplinary therapy for meningiomas","volume":"21","author":"Brastianos","year":"2019","journal-title":"Neuro-oncology"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noz061","article-title":"DNA methylation profiling to predict recurrence risk in meningioma: development and validation of a nomogram to optimize clinical management","volume":"21","author":"Nassiri","year":"2019","journal-title":"Neuro-oncology"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30155-9","article-title":"DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis","volume":"18","author":"Sahm","year":"2017","journal-title":"Lancet Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2005.01.057","article-title":"Proton beam radiotherapy versus fractionated stereotactic radiotherapy for uveal melanomas: A comparative study","volume":"63","author":"Weber","year":"2005","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0b013e3181af5cc7","article-title":"Charged particle therapy: the physics of interaction","volume":"15","author":"Lomax","year":"2009","journal-title":"Cancer J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1088\/0031-9155\/44\/1\/014","article-title":"Intensity modulation methods for proton radiotherapy","volume":"44","author":"Lomax","year":"1999","journal-title":"Phys Med Biol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.radonc.2018.05.001","article-title":"Radiation dose constraints for organs at risk in neuro-oncology; 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