Patterns of Failure After Postoperative Radiotherapy for WHO Grade 2–3 Meningiomas: A Single-Institution Experience

Background/Objectives: World Health Organization (WHO) Grade 2–3 meningiomas have high recurrence rates despite postoperative radiotherapy. This study aimed to characterize patterns of failure and clinical outcomes after postoperative external beam radiotherapy.

Methods

We retrospectively analyzed 10 patients with WHO Grade 2 (n = 6) or Grade 3 (n = 4) meningiomas treated at a single institution between January 2017 and May 2024. Nine patients underwent gross total resection. Radiotherapy was delivered using three-dimensional conformal radiotherapy (n = 6) or intensity-modulated radiotherapy (n = 4), with a median dose of 60 Gy in 30 fractions. Recurrence patterns were assessed relative to the high-dose region.