Treatment of Meningioma of Brain in Germany

Meningioma is one of the most common central nervous system tumors. It grows from the cells of the meninx serosa. This tumor is often fused to the dura mater and bone. It is usually benign but in certain cases can transform and acquire signs of malignancy. In most cases radical removal of the meningioma cures cancer. In the case of malignant tumors, as well as in the case of incomplete removal of the tumor, radiation therapy is indicated in addition to surgical treatment. Germany offers the full range of medical services aimed at determining the histological type of meningioma and performing its precise destruction. Neurosurgical interventions in German hospitals allow avoiding neurological complications and preserving high quality of life.

Content

1. Treatment methods for meningioma
2. Principles of surgical treatment for meningioma
3. How is the operation carried out?
4. Radiation therapy for meningioma
5. Treatment results for meningioma
6. Why is it better to undergo treatment of meningioma in Germany?
7. Treatment in Germany with Booking Health

Treatment methods for meningioma

The following 2 main treatment methods are used for meningiomas:

• Surgery, including the stereotactic radiosurgery
• Radiation therapy

Chemotherapy is not usually carried out due to its poor efficacy. Most meningiomas have extremely low sensitivity to drugs.

Surgical treatment is usually performed first, and then radiation therapy can be prescribed for both benign and malignant meningiomas. Irradiation can also be used for small tumors as a radical procedure (without surgery).

Symptomatic treatments for patients with meningioma includes administration of anti-seizure medications, steroids, and antidepressant medications. These do not solve the problem itself but help in improving the patient's general health state.

Principles of surgical treatment for meningioma

Surgical treatment of meningioma can be radical and palliative.

Radical surgery is aimed at the total removal of the brain tumor in order to cure the disease, or at least to achieve a long period without recurrence. As a rule, the disease can be completely cured, since the meningiomas are benign in most cases.

In advanced cases, palliative surgical treatment is performed in large and aggressive brain tumors. It is aimed at normalizing the outflow of cerebrospinal fluid, elimination of symptoms, prevention of complications.

If possible, the doctor seeks to achieve the following during performing the radical surgery:

• The greatest possible radicality of the operation – total removal of the tumor along with the area from which it grows
• Removal of meningioma through a minimal, but adequate to the volume of the operation, trepanation hole
• Do not damaging functionally important brain areas and do not causing neurological deficits
• Avoid damaging large nerves and blood vessels

In Germany, surgical treatment is carried out by experienced professionals. The state-of-art equipment of neurosurgical clinics allows the doctors to visualize all brain areas, determine their functional activity, and choose the best surgical access. The tumor is removed totally, if possible, along with the adjacent dura mater and bone. If the matrix (place from which the tumor grows) is not removed, then it is coagulated with a laser. This reduces the risk of relapse development.

The treatment in Germany is not only effective but also safe. The use of microsurgical techniques during operations, high-quality intraoperative optics and neuronavigation systems allow the doctors to remove meningioma with minimal risks for the patient's health. In addition, neurological rehabilitation is usually performed after the completion of main treatment.

How is the operation carried out?

Surgical treatment is performed under general anesthesia. The doctor dissects the skin, performs craniotomy, and coagulates the dura mater to control bleeding. After creating the access to the meningioma, the neoplasm is excised. Low-density tumors can be removed with an ultrasonic aspirator dissector, which is used for destruction and follow-up aspiration of tissues.

Upon the removal of the tumor with a hard membrane and a fragment of bone, the doctor coagulates vessels, and sutures the dissected meninges. Then he closes the skull defect using both the patient's own tissues and artificial materials. At the end, the skin is sutured and a bandage is placed.

In the first 1-2 days after surgery, CT scan or MRI is performed for assessment of the results of the surgical intervention, the degree of postoperative cerebral edema, as well as for detection of possible complications (for example, haemorrhages).

Radiation therapy for meningioma

In the case of malignant meningioma or only partial removal of tumor during the surgical treatment of a benign brain tumor, it is additionally irradiated. In addition, radiation therapy is performed as the only treatment method in the following cases:

• Location of the meningioma is inconvenient for the surgical removal
• High risk of complications (elderly age, concomitant diabetes mellitus or cardiovascular pathologies)
• Contraindications for the surgical treatment
• The patient refuses surgery or chooses radiation therapy for meningiomas up to 3.5 cm in diameter

As compared to surgical treatment, radiation therapy has several advantages. It is non-invasive, safer, well tolerated by the patient and does not require long-term recovery.

In Germany, stereotactic radiotherapy and radiosurgery are performed using state-of-the-art equipment. The doctors in Germany use linear accelerators, the newest CyberKnife and Gamma Knife systems. They direct beams to the tumor from different angles, precisely targeting its contours and volume, providing minimal radiation exposure to healthy brain tissues.

Some German hospitals use proton therapy. This is a type of radiation therapy, which uses protons instead of photons. Proton therapy may replace surgical treatment in patients with skull base meningiomas. It is highly accurate and therefore does not damage the cranial nerves located in this area.

In comparable efficacy, proton therapy differs favorably from the conventional photon irradiation with its high safety. Protons release energy only when they reach the target but not along the entire trajectory towards the tumor inside the skull. Therefore, they have much lower impact on healthy brain tissue and cause fewer complications. Proton therapy is preferred for the treatment of meningiomas in children due to its high safety. Like the other radiation therapies, proton therapy requires thorough preliminary planning with determining the precise tumor localization, size and shape.

Treatment results for meningioma

Most patients who go to Germany expect a complete recovery. As a rule, this treatment purpose is quite achievable. About 77% of all meningiomas are benign, 22% are intermediate, and only 1% of these tumors are malignant.

Grade 1 tumors are highly likely to be cured by surgery alone. If the doctor managed to remove the tumor completely, the risk of recurrence within 10 years of follow-up is only 4%. Non-radical surgical treatment increases the probability of recurrence of meningioma up to 15%. Nevertheless, the risk can be reduced by irradiation.

The recurrence of grade 2 meningioma within 3 years of follow-up occurs in 30% of patients. In case of recurrence, repeated surgical treatment or radiation therapy may be performed.

In the case of grade 3 meningioma, complete cure is unlikely, but surgical treatment can give a person a few more years of active life. The risk of recurrence of a malignant tumor within 3 years is 98%. It is difficult to remove anaplastic meningioma completely, but if the doctor managed to carry out a radical operation, then the risk of recurrence within 5 years is 78%.

Why is it better to undergo treatment of meningioma in Germany?

Surgery and radiation therapy are used in every country in the world for the treatment of meningioma, but the greatest successes in neurosurgery and neuro-oncology are achieved in developed countries, such as Germany. Therefore, many patients who can afford high-level medical services prefer to undergo surgical treatment in German hospitals.

Here are the reasons why a person may choose visiting one of the German hospitals:

• High-quality equipment – German specialists use state-of-the-art intraoperative optics, high-precision neuronavigation systems
• Many hospitals in Germany use frameless stereotaxis – it does not require fixing the stereotactic frame with screws to the patient's skull
• High-quality intraoperative diagnosis makes it possible to detect functionally important brain areas right during surgical treatment and to avoid their damage
• Experienced doctors can successfully operate even on patients with tumors in hard-to-reach localizations, including skull base meningiomas, without damaging large vessels and cranial nerves
• The latest methods of stereotactic radiation therapy and radiosurgery are used in Germany for destruction of small brain tumors without the conventional surgical interventions
• Proton therapy is available in some German hospitals. With a high cost of treatments, it is still the safest type of radiation therapy, which is sometimes used for skull base tumors and is a method of choice for children

German hospitals have the best ratio of cost of treatment and its quality. Prices here are lower than in other developed countries (USA, Japan) with the same high level of medical services.

Treatment in Germany with Booking Health

To undergo surgical treatment of meningioma in Germany, you can use the Booking Health service. Here you can receive the information about hospitals, doctors and prices. You can compare prices for a treatment in different hospitals and book a medical program at the best price.

The medical tourism operator Booking Health will arrange a trip to Germany for the surgical treatment of meningioma. We provide the following services and benefits:

• Selection of the hospital which specializes in the treatment of meningioma and achieves the best results
• Direct communication with the doctor
• Reduced waiting period for surgical treatment and appointment on the convenient date
• Reduced cost of treatment in Germany; costs are reduced due to the absence of additional coefficients for foreign patients
• Relevant information about your expenses, the cost of treatment, funds remaining in your account
• Elaboration of the program for surgical treatment of meningioma in Germany without repeating previously performed diagnostic tests
• Communication with the German hospital upon the medical program completion
• Buying and forwarding medicines
• Organization of additional diagnosis or cancer treatment in Germany

The specialists of Booking Health provide high-quality service. We will book a hotel and airline tickets for you, organize a transfer from the airport to the hospital and back.

Authors: 

The article was edited by medical experts, board-certified doctors Dr. Vadim Zhiliuk and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!

Sources:

National Library of Medicine

MedicineNet

Johns Hopkins Medicine