High-risk Meningioma: Initial Outcomes From NRG Oncology/RTOG 0539
| Autor: | Minhee Won, Hui-Kuo Shu, James M. Galvin, John de Groot, Barbara Fisher, Jignesh M. Modi, Michael A. Vogelbaum, Minesh P. Mehta, Lynn S. Ashby, Shannon Fogh, Nimisha Deb, Peixin Zhang, C. Leland Rogers, Anthony M. Alleman, Emad Youssef, Clifford G. Robinson, Young Kwok, Arie Perry, William McMillan, Valerie Panet-Raymond |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Risk Cancer Research medicine.medical_specialty Article Meningioma 03 medical and health sciences 0302 clinical medicine Recurrence Clinical endpoint Humans Medicine Radiology Nuclear Medicine and imaging Adverse effect Survival analysis Aged Radiation Grade III Meningioma business.industry Common Terminology Criteria for Adverse Events Middle Aged medicine.disease Survival Analysis Clinical trial Oncology 030220 oncology & carcinogenesis Cohort Female Radiotherapy Intensity-Modulated Radiology Neoplasm Grading Safety business 030217 neurology & neurosurgery |
| Zdroj: | Int J Radiat Oncol Biol Phys |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2019.11.028 |
| Popis: | BACKGROUND: Phase 2 cooperative group meningioma trial assessing the safety and efficacy of risk-adaptive management strategies. This is the initial analysis of the high-risk cohort. METHODS AND MATERIALS: High-risk patients were those with a new or recurrent World Health Organization (WHO) grade III meningioma of any resection extent, recurrent WHO grade II of any resection extent, or new WHO grade II after subtotal resection. Patients received intensity-modulated radiotherapy (IMRT) using a simultaneous integrated boost technique (60 Gy high dose and 54 Gy low dose in 30 fractions). Three-year progression-free survival (PFS) was the primary endpoint. Adverse events (AEs) were scored per NCI Common Terminology Criteria for Adverse Events version 3. RESULTS: Of 57 enrolled patients, 53 received protocol treatment. Median follow-up was 4.0 years (4.8 years for living patients). Two patients withdrew without progression before year 3; for the remaining 51 patients, 3-year PFS was 58.8%. Among all 53 protocol-treated patients, 3-year PFS was 59.2%. Three-year local control was 68.9%, and overall survival was 78.6%. Of 51 patients, 1 patient (1.9%) experienced a late grade-5 necrosis-related AE. All other acute (23 of 53 patients) and late (21 of 51 patients) AEs were grades 1 to 3. CONCLUSIONS: Patients with high-risk meningioma treated with IMRT (60 Gy/30) experienced 3-year PFS of 58.8%. Combined acute and late AEs were limited to grades 1 to 3, except for a single necrosis-related grade 5 event. These results support postoperative IMRT for high-risk meningioma and invite ongoing investigations to improve outcomes further. © 2019 Elsevier Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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