1. Low-risk meningioma: Initial outcomes from NRG Oncology/RTOG 0539.
- Author
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Rogers, C Leland, Pugh, Stephanie L, Vogelbaum, Michael A, Perry, Arie, Ashby, Lynn S, Modi, Jignesh M, Alleman, Anthony M, Barani, Igor J, Braunstein, Steve, Bovi, Joseph A, de Groot, John F, Whitton, Anthony C, Lindhorst, Scott M, Deb, Nimisha, Shrieve, Dennis C, Shu, Hui-Kuo, Bloom, Beatrice, Machtay, Mitchell, Mishra, Mark V, Robinson, Clifford G, Won, Minhee, and Mehta, Minesh P
- Subjects
Clinical Trials and Supportive Activities ,Patient Safety ,Clinical Research ,Humans ,Meningioma ,Radiotherapy ,Adjuvant ,Progression-Free Survival ,Risk ,Meningeal Neoplasms ,Retrospective Studies ,cooperative group trial ,meningioma ,observation ,surgery ,WHO grade 1 ,Neurosciences ,Oncology and Carcinogenesis ,Oncology & Carcinogenesis - Abstract
BackgroundThree- and five-year progression-free survival (PFS) for low-risk meningioma managed with surgery and observation reportedly exceeds 90%. Herewith we summarize outcomes for low-risk meningioma patients enrolled on NRG/RTOG 0539.MethodsThis phase II trial allocated patients to one of three groups per World Health Organization grade, recurrence status, and resection extent. Low-risk patients had either gross total (GTR) or subtotal resection (STR) for a newly diagnosed grade 1 meningioma and were observed after surgery. The primary endpoint was 3-year PFS. Adverse events (AEs) were scored using Common Terminology Criteria for Adverse Events (CTCAE) version 3.ResultsAmong 60 evaluable patients, the median follow-up was 9.1 years. The 3-, 5-, and 10-year rates were 91.4% (95% CI, 84.2 to 98.6), 89.4% (95% CI, 81.3 to 97.5), 85.0% (95% CI, 75.3 to 94.7) for PFS and 98.3% (95% CI, 94.9 to 100), 98.3%, (95% CI, 94.9 to 100), 93.8% (95% CI, 87.0 to 100) for overall survival (OS), respectively. With centrally confirmed GTR, 3/5/10y PFS and OS rates were 94.3/94.3/87.6% and 97.1/97.1/90.4%. With STR, 3/5/10y PFS rates were 83.1/72.7/72.7% and 10y OS 100%. Five patients reported one grade 3, four grade 2, and five grade 1 AEs. There were no grade 4 or 5 AEs.ConclusionsThese results prospectively validate high PFS and OS for low-risk meningioma managed surgically but raise questions regarding optimal management following STR, a subcohort that could potentially benefit from adjuvant therapy.
- Published
- 2023