Low-risk meningioma: Initial outcomes from NRG Oncology/RTOG 0539

C. Leland Rogers, Stephanie L. Pugh, Michael A. Vogelbaum, Arie Perry, Lynn S. Ashby, Jignesh M. Modi, Anthony M. Alleman, Igor J. Barani, Steve Braunstein, Joseph A. Bovi, John F. de Groot, Anthony C. Whitton, Scott M. Lindhorst, Nimisha Deb, Dennis C. Shrieve, Hui Kuo Shu, Beatrice Bloom, Mitchell Machtay, Mark V. Mishra, Clifford G. RobinsonMinhee Won, Minesh P. Mehta

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

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.

Original languageEnglish
Pages (from-to)137-145
Number of pages9
JournalNeuro-oncology
Volume25
Issue number1
DOIs
StatePublished - Jan 5 2023

Keywords

  • WHO grade 1 (benign)
  • cooperative group trial
  • meningioma
  • observation
  • surgery

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