Intermediate-Risk Meningioma: Initial Outcomes from NRG Oncology/RTOG-0539

Abstract

(Q1, 0.25; Q3, 0.44) for metastatic lesions, P < .0001. Significant differences were noted based on the site of breast metastases. The median RSIs for metastases in descending order of radioresistance were bone (0.50), brain (0.44), skin (0.44), ovary (0.43), liver (0.34), lung (0.32), and lymph nodes (0.31), P < .0001. When we restricted our analysis to patients with both a primary and metastatic lesion available for analysis (n Z 99), similar differences in radiosensitivity were noted. Primary lesions continued to be more resistant than metastatic lesions 0.38 (Q1, 0.31; Q3, 0.45) versus 0.36 (Q1, 0.21; Q3, 0.44), P Z .002. The median RSIs in descending order of radioresistance, when restricting the analysis to this subgroup, also revealed significant differences: skin (0.44), brain (0.43), ovary (0.42), lymph nodes (0.35), lung (0.29), and liver (0.26); P Z .007. Conclusion: In this novel analysis assessing radiosensitivity between primary and metastatic tissues of breast cancer histology, significant differences were noted based on anatomical location. Validation with clinical endpoints is needed but these findings could have implications on radiation dose selection based upon tumor location.

Gross total resection and adjuvant radiotherapy most significant predictors of improved survival in patients with atypical meningioma

“…The preliminary results (in abstract form) of the phase 2 NRG/Radiation Therapy Oncology Group (RTOG) 0539 study found that a combination of surgery/RT led to significantly improved progression-free survival in a group of patients treated for recurrent grade 1 lesions and completely resected atypical lesions. 26 This will be tested in the future with NRG Oncology protocol BN-003 and the ongoing Radiation versus Observation following surgical resection of Atypical Meningioma (ROAM)/European Organization for Research and Treatment of Cancer (EORTC)-1308 trial, for which, based on the results of the current study, we would support patient enrollment for the evaluation of disease-free-survival. 27 Although studies to date have demonstrated improvement in disease control with RT, the results of the current study (which we believe to have enough patients and follow-up) actually suggested that this improved control is likely to lead to improved survival in the future.…”

“…An important difference in the current study is that the sample size was 3 times larger, which perhaps provided enough power to allow for significance to materialize. The preliminary results (in abstract form) of the phase 2 NRG/Radiation Therapy Oncology Group (RTOG) 0539 study found that a combination of surgery/RT led to significantly improved progression‐free survival in a group of patients treated for recurrent grade 1 lesions and completely resected atypical lesions . This will be tested in the future with NRG Oncology protocol BN‐003 and the ongoing Radiation versus Observation following surgical resection of Atypical Meningioma (ROAM)/European Organization for Research and Treatment of Cancer (EORTC)‐1308 trial, for which, based on the results of the current study, we would support patient enrollment for the evaluation of disease‐free‐survival .…”

Lessons learned from reirradiation of recurrent skull base meningioma: A case report and review of the literature

“…Target volumes were defined by the tumor bed on the postoperative MRI scan, including any nodular enhancement but excluding cerebral edema and the dural tail. A CTV margin of 1.0 cm was recommended except along natural barriers (eg, skull base) where a 0.5 cm margin was permitted, provided there was no evidence of bone invasion 9 . For reference, an RTOG-style GTV and CTV are included in Fig 4.…”

Contact lens‐type ocular in vivo dosimeter for radiotherapy

“…The dose for the eye lens is also a matter of concern in radiation therapy. The dose limit has been set to 7 Gy via the Radiation Therapy Oncology Group 0539 and 0825 studies . For tolerance doses, Emami et al reported that if the lens receives a dose of more than 10 Gy, the risk of developing cataract is 5% within/after 5 yr (TD 5/5) .…”

“…The dose limit has been set to 7 Gy via the Radiation Therapy Oncology Group 0539 and 0825 studies. 11,12 For tolerance doses, Emami et al reported that if the lens receives a dose of more than 10 Gy, the risk of developing cataract is 5% within/after 5 yr (TD 5/5). 13 This tolerance dose was defined for the conventional prescription of 1.8 or 2 Gy in a fraction, five fractions per week.…”