High-risk Meningioma: Initial Outcomes From NRG Oncology/RTOG 0539
High-risk Meningioma: Initial Outcomes From NRG Oncology/RTOG 0539
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DOI：
10.1016/j.ijrobp.2019.11.028
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发表时间：
2020-03-15
影响因子：
7
通讯作者：
Mehta, Minesh P.
中科院分区：
文献类型：
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作者：
Rogers, C. Leland;Won, Minhee;Mehta, Minesh P.
背景：2期合作组脑膜瘤试验评估风险适应性管理策略的安全性和有效性。这是最初的分析high-risk cohol.Methods和材料：高危患者是那些新的或复发的世界卫生组织（WHO）III级脑膜瘤的任何切除范围，复发的WHO II级的任何切除范围，或新的WHO II级次全切除术后。患者接受调强放射治疗（IMRT），采用同步整合增强技术（60戈伊高剂量和54戈伊低剂量，分30次）。3年无进展生存期（PFS）是主要终点。根据NCI不良事件通用术语标准第3版对不良事件（AE）进行评分。结果：在57例入组患者中，53例接受了方案治疗。中位随访时间为4.0年（存活患者为4.8年）。2例患者在第3年前无进展退出研究;其余51例患者的3年PFS为58.8%。在所有53例方案治疗患者中，3年PFS为59.2%。3年局部控制率为68.9%，总生存率为78.6%。在51例患者中，1例患者（1.9%）发生了晚期5级坏死相关AE。所有其他急性（53例患者中的23例）和晚期（51例患者中的21例）AE均为1 - 3级。结论：接受IMRT（60戈伊/30）治疗的高危脑膜瘤患者3年PFS为58.8%。合并的急性和晚期AE仅限于1 - 3级，但1起5级坏死相关事件除外。这些结果支持高危脑膜瘤的术后调强放射治疗，并邀请正在进行的调查，以进一步改善结果。(C)2019爱思唯尔公司All rights reserved.
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. (C) 2019 Elsevier Inc. All rights reserved.