Low-risk meningioma: Initial outcomes from NRG Oncology/RTOG 0539 Journal Articles uri icon

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abstract

  • Abstract Background Three- 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. Methods This 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. Results Among 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. Conclusions These 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.

authors

  • 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
  • Lindhorst, Scott M
  • Deb, Nimisha
  • Shrieve, Dennis C
  • Shu, Hui-Kuo
  • Bloom, Beatrice
  • Machtay, Mitchell
  • Mishra, Mark V
  • Robinson, Clifford G
  • Won, Minhee
  • Mehta, Minesh P

publication date

  • January 5, 2023