Adjuvant Hypofractionated Stereotactic Radiosurgery for Intermediate-risk Meningioma

PRIMARY OBJECTIVE: I. To evaluate the safety of adjuvant hypofractionated stereotactic radiosurgery after gross total resection of intermediate risk meningioma. SECONDARY OBJECTIVES: I. To report the efficacy of adjuvant hypofractionated stereotactic radiosurgery in participants with intermediate risk meningioma. II. To evaluate the 3-year overall survival rate of participants treated with adjuvant stereotactic radiosurgery. III. To report on the financial impact, quality of life, and treatment burden of participants who undergo adjuvant stereotactic radiosurgery. EXPLORATORY OBJECTIVES: I. To prospectively collect and assess a prognostic and predictive gene expression panel biomarker and deoxyribonucleic acid (DNA) methylation based genomic classification systems for meningioma. II. To report the comparative dosimetry of adjuvant stereotactic radiosurgery as compared to simulated external beam plans generated based on the drawn planning target volumes. OUTLINE: Participants undergo hypofractionated stereotactic radiosurgery over 15-30 minutes once daily (QD) on days 1-5 in the absence of disease progression or unacceptable toxicity. Additionally, participants undergo magnetic resonance imaging (MRI) throughout the study and may undergo computed tomography (CT) as necessary. After completion of study treatment, participants are followed up at months 3 and 6 and then at years 1, 2 and 3.