Adjuvant postoperative high-dose radiotherapy for atypical and malignant meningioma: A phase-II parallel non-randomized and observation study (EORTC 22042-26042)

The therapeutic strategy for non-benign meningiomas is controversial. The objective of this study was to prospectively investigate the impact of high dose radiation therapy (RT) on the progression-free survival (PFS) rate at 3 years in WHO grade II and III meningioma patients. In this multi-cohorts...

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Published in:Radiotherapy and oncology Vol. 128; no. 2; pp. 260 - 265
Main Authors: Weber, Damien C., Ares, Carmen, Villa, Salvador, Peerdeman, Saskia M., Renard, Laurette, Baumert, Brigitta G., Lucas, Anna, Veninga, Theo, Pica, Alessia, Jefferies, Sarah, Ricardi, Umberto, Miralbell, Raymond, Stelmes, Jean-Jacques, Liu, Yan, Collette, Laurence, Collette, Sandra
Format: Journal Article
Language:English
Published: Ireland Elsevier B.V 01.08.2018
Subjects:
Adult
Aftercare
Aged
Atypical meningioma
Disease-Free Survival
Dose escalation
Female
Humans
Male
Malignant meningioma
Meningeal Neoplasms - mortality
Meningeal Neoplasms - radiotherapy
Meningeal Neoplasms - surgery
Meningioma - mortality
Meningioma - radiotherapy
Meningioma - surgery
Middle Aged
Observational study
Phase II trial
Postoperative Care - methods
Radiotherapy
Radiotherapy Dosage
Radiotherapy, Adjuvant - adverse effects
Radiotherapy, Adjuvant - methods
Retrospective Studies
Treatment Failure
Atypical meningioma
Observational study
Malignant meningioma
Dose escalation
Radiotherapy
Phase II trial
ISSN:0167-8140, 1879-0887, 1879-0887
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Summary:The therapeutic strategy for non-benign meningiomas is controversial. The objective of this study was to prospectively investigate the impact of high dose radiation therapy (RT) on the progression-free survival (PFS) rate at 3 years in WHO grade II and III meningioma patients. In this multi-cohorts non-randomized phase II and observational study, non-benign meningioma patients were treated according to their WHO grade and Simpson’s grade. Patients with atypical meningioma (WHO grade II) and Simpson’s grade 1–3 [Arm 1] entered the non-randomized phase II study designed to show a 3-year PFS > 70% (primary endpoint). All other patients entered the 3 observational cohorts: WHO grade II Simpson grade 4–5 [Arm 2] and Grade III Simpson grade 1–3 or 4–5 [Arm 3&4] in which few patients were expected. Between 02/2008 and 06/2013, 78 patients were enrolled into the study. This report focuses on the 56 (median age, 54 years) eligible patients with WHO grade II Simpson’s grade 1–3 meningioma who received RT (60 Gy). At a median follow up of 5.1 years, the estimated 3-year PFS is 88.7%, hence significantly greater than 70%. Eight (14.3%) treatment failures were observed. The 3-year overall survival was 98.2%. The rate of late signs and symptoms grade 3 or more was 14.3%. These data show that 3-year PFS for WHO grade II meningioma patients undergoing a complete resection (Simpson I–III) is superior to 70% when treated with high-dose (60 Gy) RT.
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ISSN:0167-8140
1879-0887
1879-0887
DOI:10.1016/j.radonc.2018.06.018