**Abstract**

Meningiomas are the second common Central Nervous System (CNS) neoplasm, and are the most common benign intracranial tumor. They approximately constitute up to 30% of all intracranial tumors. They arise from the arachnoidal coverings of brain. Presentation varies and depends on size, number and location of tumors. Symptoms include those related to increased in intracranial pressure, local irritative features including seizure and local pressure effect to eloquent areas, white matter tracts and cranial nerves. Management of meningiomsa is always challenging and multi-disciplinary approaches includes surgery, radiotherapy and possible chemotherapy and immunotherapy. Among radiation therapy treatment, stereotactic radiosurgery (SRS) or stereotactic radiosurgery (SRT) is getting the popularity compared to traditional conformal radiotherapy with comparable tumor control rate.

**Keywords:** intracranial meningioma, stereotactic radiosurgery, stereotactic radiotherapy, LINAC, Gamma Knife, CyberKnife

### **1. Introduction**

Meningiomas are the second common Central Nervous System (CNS) neoplasm, and are the most common benign intracranial tumor. They approximately constitute up to 30% of all intracranial tumors. They arise from the arachnoidal coverings of brain. Presentation varies and depends on size, number and location of tumors. Symptoms include those related to increased in intracranial pressure, local irritative features including seizure and local pressure effect to eloquent areas, white matter tracts and cranial nerves. Management of meningiomsa is always challenging and multi-disciplinary approaches includes surgery, radiotherapy and possible chemotherapy and immunotherapy. Among radiation therapy treatment, stereotactic radiosurgery (SRS) or stereotactic radiosurgery (SRT) is getting the popularity compared to traditional conformal radiotherapy with comparable tumor control rate. This chapter is intended to discuss the overview of radiosurgery on management of intracranial meningiomas with more focus on the outcome related to location of tumors and different modalities of radiosurgery, and sharing of the local experience of our centre.

### **2. Epidemiology**

The overall age-adjusted incidence is about 8.6 per 100,000 of all primary brain and spinal cord tumors. The incidence rates are correlated with ages, with a median age at diagnosis of 66 years. Tumors are reported to be 1.5 to 3 times more frequent in women. Under the World Health Organization (WHO) classification of brain tumors, majority of the tumors around 80–85% are grade I, around 15–20% are grade II, with 1–2% confirmed to be grade III malignant [1].
