Long-Term Analysis of NRG Oncology RTOG 0539: A Phase II Trial of Observation for Low-Risk Meningioma and Radiotherapy for Intermediate- and High-Risk Meningioma
Abstract
NRG Oncology RTOG 0539 was a prospective phase II trial of risk-adapted radiotherapy for patients with WHO grade 1-3 meningioma. Low-risk (group 1, n = 60) was defined as a grade 1 tumor after gross total resection or subtotal resection (GTR/STR) and prospectively monitored. Intermediate-risk (group 2, n = 52) was defined as recurrent grade 1 or newly diagnosed grade 2 tumor after GTR and treated with radiotherapy (54 Gy). High-risk (group 3, n = 53) included a newly diagnosed grade 2 tumor after STR, newly diagnosed grade 3 tumor, or recurrent grade 2 or 3 tumor and treated with radiotherapy (60 Gy). Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. The median follow-up times for the low-, intermediate-, and high-risk cohorts were 12.1, 12.0, and 11.1 years, respectively. The 10-year PFS and OS rates for the low-, intermediate-, and high-risk cohorts were 85.2% and 94.1%, 72.2% and 84.7%, and 42.5% and 51.1%, respectively. Five patients (9.6%) and eight patients (15.1%) had a grade 3+ toxicity attributed to radiotherapy in the intermediate- and high-risk cohorts, respectively. The long-term outcomes using this risk-adapted approach support observation for low-risk patients, inform radiotherapy patient selection and practice standards for intermediate- and high-risk patients, and provide comparative benchmarks for future trials.
Article Details
Journal Info
Journal of Clinical Oncology
Lippincott Williams & Wilkins
Authors (26)
Rupesh Kotecha
Mei-Yin Polley
NRG Oncology Statistics and Data Management Center, Chicago, IL
Michael A. Vogelbaum
Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
Arie Perry
Lynn Ashby
Saint Joseph's Hospital and Medical Center, Phoenix, AZ
Jignesh M. Modi
Midstate Medical Center, Meriden, CT
Anthony M. Alleman
University of Oklahoma Health Sciences Center, Oklahoma City, OK
Christina I. Tsien
The Research Institute of the McGill University Health Centre, Montreal, QC, Canada
Igor Johan Barani
Barrow Neurological Institute, Phoenix, AZ
Jing Li
Steve Braunstein
Anthony C. Whitton
Hamilton Health Sciences Center, Hamilton, ON, Canada
Joseph A. Bovi
Medical College of Wisconsin, Milwaukee, WI
Nimisha Deb
WellSpan Health, Lebanon, PA
Scott M. Lindhorst
Medical University of South Carolina, Charleston, SC
Dennis C. Shrieve
University of Utah Health, Salt Lake City, UT
Clifford G. Robinson
Siteman Cancer Center at Washington University, Saint Louis, MO
Hui-Kuo G. Shu
Winship Cancer Institute of Emory University, Atlanta, GA
Prashant Vempati
Case Western Reserve University, Cleveland, OH
Mark Vikas Mishra
University of Maryland, Baltimore, MD
John H. Suh
Cleveland Clinic, Cleveland, OH
Beatrice Bloom
Northwell Health/Center for Advanced Medicine, Lake Success, NY
Grant K. Hunter
Intermountain Health, Salt Lake City, UT
Minhee Won
NRG Oncology Statistics and Data Management Center, Chicago, IL
Minesh P. Mehta
C. Leland Rogers
Utah Cancer Specialists, Salt Lake City, UT