ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2026
Incidence of radiation necrosis following different radiotherapy fractionation schedules for intracranial meningiomas.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Obstacles and Trials in Treating Primary Brain Tumors.International journal of molecular sciences · 2026Review
- Cerebral Radionecrosis Following Stereotactic Irradiation of Skull Bone Metastases: A Diagnostic Pitfall to Be Aware of.Diagnostics (Basel, Switzerland) · 2026Article
- Advances in the prevention and treatment of radiation-induced brain necrosis: a narrative review.Frontiers in oncology · 2026Review
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Authors and funding
11 authors.
Funding
Abstract
background and purposeRadiotherapy (RT) may be a safe alternative to surgery for selected intracranial meningiomas, particularly in eloquent or high-risk surgical locations. Reported studies of stereotactic RT have utilized stereotactic radiosurgery (SRS), fractionated stereotactic radiotherapy (hFSRT), or conventional radiotherapy. This retrospective study aimed to compare toxicity in a large international cohort. MATERIALS AND
methodsA total of 473 consecutive patients were treated for intracranial meningioma at two radiation oncology clinics. The patients underwent various treatment modalities, including stereotactic radiosurgery (SRS), hypofractionated stereotactic radiotherapy (hFSRT, 2-5 fractions), or normofractionated stereotactic radiotherapy (nFSRT, 28-30 fractions) using CT-linac or Cyberknife radiation techniques. The evaluation of potential brain edema and radiation necrosis (RN) was conducted using magnetic resonance imaging (MRI).
resultsRadiation-induced brain edema occurred in 11.0% of patients, including 4.9% with symptomatic edema requiring corticosteroid therapy, and 4.0% of patients developed radiation necrosis. Despite a smaller irradiated tumor volume, the risk of radiation-related toxicity was higher with SRS compared to hFSRT and nFSRT, for both brain edema (hazard ratio [HR] = 4.10, 95% confidence interval (CI; 2.02; 8.26), p < 0.001) and RN (HR = 11.07, 95% CI (2.65; 46.24), p < 0.001). Cox regression showed a 33 and 28% increased risk of brain edema and RN per 1 cm
conclusionStereotactic radiotherapy and radiosurgery are safe treatment options for intracranial meningiomas. However, our data indicate a significantly increased risk of radiation necrosis and edema after SRS for tumors larger than 2 cm
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