Meningioma medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ifeoma Odukwe, M.D. [2] Haytham Allaham, M.D. [3]


Patients presenting with asymptomatic meningiomas are usually managed conservatively with the decision to undergo surgery being based on the patient's age, clinical presentation, and location of the tumor. In symptomatic patients, surgery is the definite management method. Though chemotherapy is not necessarily used in the treatment of meningioma, hydroxyurea can be used as an adjuvant therapy after incomplete resection of an atypical meningioma in cases where adjuvant radiotherapy cannot be done. There is no difference in the mean progression-free survival between both therapies.

Medical Therapy

Conservative Management

  • In asymptomatic meningiomas, the decision of surgical resection must be weighed against the possibility of conservative management according to the patient's age, clinical presentation, and the anatomical location of the tumor.[1]
  • Conservative management with observation and close imaging follow-up is recommended among certain patients with small sized asymptomatic meningioma.
  • Meningiomas are more likely to grow in size on repeated imaging studies among patients younger than 60 years of age; thus conservative management is not recommended in these patients.
  • Conservative management is not recommended among symptomatic meningioma patients.



  1. Herscovici Z, Rappaport Z, Sulkes J, Danaila L, Rubin G (2004). "Natural history of conservatively treated meningiomas". Neurology. 63 (6): 1133–4. PMID 15452322.
  2. 2.0 2.1 2.2 Kim J, Kim KH, Kim YZ (2017). "The Clinical Outcome of Hydroxyurea Chemotherapy after Incomplete Resection of Atypical Meningiomas". Brain Tumor Res Treat. 5 (2): 77–86. doi:10.14791/btrt.2017.5.2.77. PMC 5700031. PMID 29188208.

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