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Rogers CL, Pugh SL, Vogelbaum MA, Perry A, Ashby LS, Modi JM, Alleman AM, Barani IJ, Braunstein S, Bovi JA, de Groot JF, Whitton AC, Lindhorst SM, Deb N, Shrieve DC, Shu HK, Bloom B, Machtay M, Mishra MV, Robinson CG, Won M, Mehta MP. Low-risk meningioma: Initial outcomes from NRG Oncology/RTOG 0539. Neuro Oncol 2022; 25:137-145. [PMID: 35657335 PMCID: PMC9825319 DOI: 10.1093/neuonc/noac137] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Indexed: 01/12/2023] Open
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.
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Affiliation(s)
- C Leland Rogers
- Corresponding Author: C. Leland Rogers, MD, GammaWest Cancer Services, 3592 West 9000 South, Suite 100, West Jordan, UT 84088, USA ()
| | - Stephanie L Pugh
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania, USA
| | | | - Arie Perry
- University of California, San Francisco, Neuropathology, San Francisco, California, USA
| | - Lynn S Ashby
- Barrow Neurological Institute, Neurology, Phoenix, Arizona, USA
| | - Jignesh M Modi
- MidState Medical Center, Radiology, Meriden, Connecticut, USA
| | | | - Igor J Barani
- Barrow Neurological Institute, Radiation Oncology, Phoenix, Arizona, USA
| | - Steve Braunstein
- University of California, San Francisco, Radiation Oncology, San Francisco, California, USA
| | - Joseph A Bovi
- Medical College of Wisconsin, Radiation Oncology, Milwaukee, Wisconsin, USA
| | - John F de Groot
- University of California, San Francisco, Neuro Oncology, San Francisco, California, USA
| | - Anthony C Whitton
- Juravinski Cancer Centre, Radiation Oncology, Hamilton, Ontario, Canada
| | - Scott M Lindhorst
- Medical University of South Carolina, Neuro Oncology, Charleston, South Carolina, USA
| | - Nimisha Deb
- St. Luke’s Hospital-Anderson Campus Cancer Center, Easton, Pennsylvania, USA
| | - Dennis C Shrieve
- Huntsman Cancer Institute, Radiation Oncology, University of Utah, Salt Lake City, Utah, USA
| | - Hui-Kuo Shu
- Winship Cancer Institute at Emory University, Radiation Oncology, Atlanta, Georgia, USA
| | - Beatrice Bloom
- Northwell Health, Radiation Oncology, New Hyde Park, New York, USA
| | - Mitchell Machtay
- Penn State Cancer Institute, Radiation Oncology, Hershey, Pennsylvania, USA
| | - Mark V Mishra
- University of Maryland, Radiation Oncology, Baltimore, Baltimore, Maryland, USA
| | - Clifford G Robinson
- Washington University, Radiation Oncology, St. Louis, St. Louis, Missouri, USA
| | - Minhee Won
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania, USA
| | - Minesh P Mehta
- Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, USA
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