A study looking at radiotherapy after surgery to treat a type of brain tumour called meningioma

Cancer type:

Brain (and spinal cord) tumours

Status:

Results

Phase:

Phase 2

This study looked at radiotherapy after surgery to help prevent meningioma coming back.

A meningioma is a tumour that starts in the membrane (meninges) covering the brain and spinal cord. They are usually benign (not cancerous). Although benign meningiomas (grade 1) are slow growing, other meningiomas can grow more quickly. Doctors call these atypical (grade 2) or malignant (grade 3) meningiomas.

This study was for people who had a grade 2 or grade 3 meningioma.

It was open for people to join between 2008 and 2013, and these results were published in 2018.

More about this trial

Surgery is a usual treatment for meningioma. But those that grow more quickly can come back again (relapse). So, doctors sometimes give another treatment such as radiotherapy to help prevent relapse. But when researchers did this study, it wasn’t clear if radiotherapy helped or whether a higher dose was needed.

In this study, researchers gave high dose radiotherapy to people who’d had surgery to remove the meningioma.

The aims of this study were to find out:

if high dose radiotherapy helped stop the meningioma coming back
how well people coped with having radiotherapy
more about the side effects

Summary of results

These results focused on people with a grade 2 meningioma who had all their meningioma removed. The study team found that high dose radiotherapy improved treatment for this group of people.

About this study

78 people joined this study. Of those:

69 had a grade 2 meningioma
9 had a grade 3 meningioma

The number of radiotherapy treatments they had depended on whether their meningioma could be completely removed or not.

For people who had a grade 2 meningioma:

56 had their meningioma completely removed and 30 radiotherapy treatments (group 1)
12 had part of their meningioma removed and 35 radiotherapy treatments (group 2)

For people who had a grade 3 meningioma:

7 had their meningioma completely removed and 30 radiotherapy treatments (group 3)
2 had part of their meningioma removed and 35 radiotherapy treatments (group 4)

Radiotherapy started 6 weeks after surgery. Out of the total of 77 people planned for radiotherapy, 74 actually went on to have treatment.

Results

The results published so far included 56 people who had surgery to remove all the grade 2 meningioma. Of those, 51 people had radiotherapy.

Researchers followed everyone up for an average of 5 years.

They looked at the number of people living whose meningioma hadn’t started to grow again. They found that at 3 years, this was 47 people.

They also looked at the number of people living after treatment. At 3 years this was 53 people.

They compared these results to other studies using standard dose radiotherapy. Researchers report that high dose radiotherapy worked better at preventing recurrence than previous standard radiotherapy.

The trial team are doing further analysis on people who had part of the meningioma removed. And on those who had a grade 3 meningioma. We hope to add these results when they become available.

Radiotherapy and the brain

People who took part had regular tests to check their:

memory
ability to carry out simple instructions and tasks

This is because having radiotherapy to the brain could affect these. But the end of study tests showed there was no change compared to tests done at the beginning. So, for these people having high dose radiotherapy didn’t affect their brain function.

Side effects

5 people had serious side effects that were likely to be related to radiotherapy. Of those:

3 had fits (seizures)
1 had eye damage
1 didn’t have enough blood flow to the brain

Conclusion

The study team found that high dose radiotherapy after surgery to completely remove grade 2 meningioma worked well compared to previous reports of lower doses of radiotherapy.

Radiotherapy can lead to side effects. So, researchers say it is best to give it to those who have the highest risk of the meningioma coming back.

The ROAM (EORTC 1308) trial is looking at high dose radiotherapy for grade 2 meningioma that has been completely removed. We have a summary of ROAM on the CRUK trials database.

Where this information comes from

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item

) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.