Clinical, pathological and molecular aspects of meningiomas and treatment options

Vollständiger Abstract

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Meningiomas are the most common primary intracranial tumors in adults, accounting for over 35 % of all intracranial tumors. Moreover, meningiomas occurring in children account for only 0.64 % of all meningiomas, and among intracranial tumors in children, meningiomas account for 1.42–5.00 % of cases. Because the risk of developing meningioma increases significantly with age, the proportion of healthcare costs associated with meningiomas in developed countries will continue to increase as the demographics shift toward an aging population. Compared to malignant glial tumors, meningiomas have been relatively poorly studied in terms of etiologic risk factors. Meningiomas can also be part of hereditary diseases. These tumors are primarily benign and can be observed, but the preferred treatment method is complete tumor resection, which provides good results. According to the World Health Organization, 5-year survival rate for grade I meningioma is over 80 %. Meningiomas with a heterogeneous morphological picture or located in difficult-to-reach anatomical locations represent a difficult task in terms of treatment and prediction of the outcome. Radiation therapy is often used for atypical, anaplastic, recurrent, and surgically inaccessible benign meningiomas. However, the method, regimen, dose, and timing of radiation therapy remain uncertain and are areas of active research, with clinical trials ongoing. Currently, there are no universal adjuvant chemotherapy agents, so the latest advances in genomic and epigenomic research of meningiomas are being explored for potential targeted therapy. Advances in genomics and molecular characterization of meningiomas have revealed potential for more detailed classification, description of disease progression, prognosis, and estimation of recurrence rates. This review aims to analyze and summarize current data on meningiomas, their etiology, molecular characteristics, diagnostics, and treatment methods, and lists currently ongoing clinical trials.