{"id":629522,"date":"2026-09-27T23:52:25","date_gmt":"2026-09-27T23:52:25","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/629522\/"},"modified":"2026-09-27T23:52:25","modified_gmt":"2026-09-27T23:52:25","slug":"stanislav-lazarev-analyzes-roam-trial-results-adjuvant-rt-vs-observation-after-gtr-for-who-grade-2-meningioma","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/629522\/","title":{"rendered":"Stanislav Lazarev Analyzes ROAM Trial Results: Adjuvant RT vs. Observation After GTR for WHO Grade 2 Meningioma"},"content":{"rendered":"

Stanislav Lazarev, Radiation Oncologist, Associate Professor at Mount Sinai Health System, shared on X<\/a>:<\/p>\n

\u201cRandomized phase III trial of adjuvant RT vs observation after gross total resection of WHO grade 2 meningioma just got published.<\/p>\n

157 pts:<\/p>\n

78 RT
\n79 observation
\nRT = 60 Gy\/30 fx
\nmedian follow-up ~5 years<\/p>\n

At ~5 years:<\/p>\n

Recurrence: 14% with RT vs 30% with obs
\n5-year DFS: 80% vs 64%<\/p>\n

There was no difference in OS, but only 13 pts died in the entire trial, and 95% CI was huge 0.27-3.05. So, one really can\u2019t tell from this study whether RT improves, worsens, or has no effect on OS. It was simply far too underpowered for that endpoint.<\/p>\n

Could salvage tx in the obs arm attenuate OS difference? Possibly. More pts in the obs arm required 2nd-line tx (20% vs 10% with RT), but ROAM doesn\u2019t quite establish that salvage tx explains the lack of OS difference \u2013 it is a plausible interpretation, but not a proven conclusion.<\/p>\n

QoL and neurocognitive outcomes were similar which is reassuring, but QoL data were available in only 38% of pts at 5 yrs, while by 2 yrs ~45% of neurocognitive data were missing. So there is simply too much missing data to conclude that either strategy leads to better or worse QoL or neurocognitive function. After all, if a tumor recurs and a pt needs salvage surgery and\/or RT, it is plausible that QoL could worsen simply from the burden of additional tx<\/p>\n

My take-home: RT reduces the risk of recurrence after GTR of grade 2 meningioma.<\/p>\n

But, just like in breast, prostate, and other cancers with otherwise favorable prognosis, there will be a sizable group of pts who would never recur even without additional tx. Here, about 70% of pts observed had not recurred at ~5 years. So, as with most things in oncology, selection is really the.<\/p>\n

I\u2019d particularly consider RT in younger patients and those with higher-risk clinical and\/or molecular features and in cases where postop 68Ga-DOTATATE PET detects residual disease that may not be clearly visible on MRI.\u201d<\/p>\n

Read the full article<\/a>.<\/p>\n

Title: Radiotherapy versus observation following surgical resection of WHO grade 2 atypical meningioma (ROAM\/EORTC-1308): an international, multicentre, open-label, phase 3, randomised controlled trial<\/p>\n

Authors: Prof Michael D Jenkinson, Anna Rosala-Hallas, Prof Felix Sahm, Prof Nicolaus Andratschke, Prof Keyoumars Ashkan, Damiano Balestrini, Helen Bulbeck, S\u00edlvia Comas, Giovanna Culeddu, Kumar Das, Laura Fariselli, Karen Fowkere, Priya Francis Efstathia Gkioni, Vassilis Golfinopoulos, Thierry Gorlia, Neda Haghighi, Brian J Haylock, Prof Dyfrig A Hughes, Mohsen Javadpour, Philippe Martinive, Helen M O Mayles, Perry Moore, Emilie Le Rhun, Nicola Rosenfelder, Gail Ryan, Michael Weller, Carrol Gamble, Matthias Preusser, Damien C Weber<\/p>\n

Matthias Preusser: Should Completely Resected WHO Grade 2 Atypical Meningiomas Receive Radiotherapy or Observation?\"Stanislav<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"Stanislav Lazarev, Radiation Oncologist, Associate Professor at Mount Sinai Health System, shared on X: \u201cRandomized phase III trial…\n","protected":false},"author":2,"featured_media":629523,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[163,85,46],"class_list":["post-629522","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-health","tag-il","tag-israel"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/629522","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=629522"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/629522\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/629523"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=629522"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=629522"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=629522"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}