Marshall Harrell, Tuğçe Kütük, Alexander Crum, Natalie M. Clark, Joshua Palmer, Raju R. Raval, Sasha Beyer, Simeng Zhu, J.C. Grecula, Dukagjin Blakaj, James Bradley Elder, R. Singh
Nodular meningeal disease (NMD) is a clinically significant recurrence pattern characterized by discrete meningeal tumor involvement, most commonly arising along the dura, and is strongly associated with neurosurgical resection followed by adjuvant stereotactic radiosurgery (SRS) [1]. Historically, whole-brain radiotherapy (WBRT) was the standard postoperative treatment, providing comprehensive coverage of microscopic disease beyond the resection cavity [2]. However, concerns over delayed neurocognitive toxicity have driven a shift away from WBRT toward focal approaches such as SRS and fractionated stereotactic radiotherapy (FSRT) [3].