TY - JOUR
T1 - Low-risk meningioma
T2 - Initial outcomes from NRG Oncology/RTOG 0539
AU - Rogers, C. Leland
AU - Pugh, Stephanie L.
AU - Vogelbaum, Michael A.
AU - Perry, Arie
AU - Ashby, Lynn S.
AU - Modi, Jignesh M.
AU - Alleman, Anthony M.
AU - Barani, Igor J.
AU - Braunstein, Steve
AU - Bovi, Joseph A.
AU - de Groot, John F.
AU - Whitton, Anthony C.
AU - Lindhorst, Scott M.
AU - Deb, Nimisha
AU - Shrieve, Dennis C.
AU - Shu, Hui Kuo
AU - Bloom, Beatrice
AU - Machtay, Mitchell
AU - Mishra, Mark V.
AU - Robinson, Clifford G.
AU - Won, Minhee
AU - Mehta, Minesh P.
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - 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.
AB - 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.
KW - WHO grade 1 (benign)
KW - cooperative group trial
KW - meningioma
KW - observation
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=85145955628&partnerID=8YFLogxK
U2 - 10.1093/neuonc/noac137
DO - 10.1093/neuonc/noac137
M3 - Article
C2 - 35657335
AN - SCOPUS:85145955628
SN - 1522-8517
VL - 25
SP - 137
EP - 145
JO - Neuro-oncology
JF - Neuro-oncology
IS - 1
ER -