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

Damien C. Weber*, Carmen Ares, Salvador Villa, Saskia M. Peerdeman, Laurette Renard, Brigitta G. Baumert, Anna Lucas, Theo Veninga, Alessia Pica, Sarah Jefferies, Umberto Ricardi, Raymond Miralbell, Jean-Jacques Stelmes, Yan Liu, Laurence Collette, Sandra Collette

*Corresponding author for this work

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Abstract

Purpose: 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. Materials and methods: 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. Results: 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%. Conclusions: 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. (C) 2018 Elsevier B.V. All rights reserved.
Original languageEnglish
Pages (from-to)260-265
Number of pages6
JournalRadiotherapy and Oncology
Volume128
Issue number2
DOIs
Publication statusPublished - 1 Aug 2018

Keywords

  • Atypical meningioma
  • Malignant meningioma
  • Phase II trial
  • Observational study
  • Radiotherapy
  • Dose escalation
  • EVIDENCE-BASED MEDICINE
  • INTRACRANIAL MENINGIOMA
  • RETROSPECTIVE ANALYSIS
  • SURGICAL RESECTION
  • RADIATION-THERAPY
  • QUALITY-ASSURANCE
  • CLINICAL ARTICLE
  • TRIAL
  • CLASSIFICATION
  • IRRADIATION

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