Brain-sparing total meningeal radiation for a patient with widespread progressive meningiomas using helical intensity modulated radiation.

Multiple meningioma is a rare but difficult clinical entity. We describe the case of a patient with widespread progressive meningiomas who could not safely have surgery or radiosurgery. We have previously treated these patients with whole brain radiation, despite the risks of neuropsychological side effects. In this case, we treated with a novel use of helical intensity modulated radiation therapy: brain-sparing total meningeal radiation. The brain-sparing technique allowed us to treat the patient's meninges with higher doses than would have been possible with whole brain radiation and with the goal of achieving long-term disease control.