Radiotherapy or Radiosurgery Compared With Observation Alone in Treating Patients With Newly Diagnosed, Benign Meningioma That Has Been Partially Removed by Surgery
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Purpose
RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Radiosurgery may be able to send x-rays directly to the tumor and cause less damage to normal tissue. Giving radiation therapy or radiosurgery after surgery may kill any remaining tumor cells. It is not yet known whether radiation therapy or radiosurgery is more effective than observation alone in treating benign meningioma.
PURPOSE: This randomized phase III trial is studying radiation therapy or radiosurgery to see how well they work compared to observation alone in treating patients with newly diagnosed, benign meningioma that has been partially removed by surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Brain and Central Nervous System Tumors |
Procedure: adjuvant therapy Radiation: radiation therapy Radiation: stereotactic radiosurgery |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Primary Purpose: Treatment |
| Official Title: | Observation Versus Conventional-Fractionated Radiotherapy or Radiosurgery After Non-radical Surgery for Benign Intracranial Meningiomas: A Phase III Study |
- Progression-free survival [ Designated as safety issue: No ]
- Quality of life [ Designated as safety issue: No ]
- Overall survival [ Designated as safety issue: No ]
- Incidence of a second surgery [ Designated as safety issue: No ]
- Acute neurotoxicity [ Designated as safety issue: Yes ]
- Long-term neurotoxicity [ Designated as safety issue: Yes ]
| Enrollment: | 9 |
| Study Start Date: | December 2004 |
| Primary Completion Date: | November 2006 (Final data collection date for primary outcome measure) |
OBJECTIVES:
Primary
- Compare progression-free survival of patients with newly diagnosed, incompletely resected, benign intracranial grade I meningioma treated with adjuvant conventional fractionated radiotherapy or radiosurgery vs observation only.
Secondary
- Compare the quality of life of patients treated with these regimens.
- Compare overall survival of patients treated with these regimens.
- Compare the incidence of a second surgery in patients treated with these regimens.
- Compare the incidence of acute and long-term neurotoxicity in patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to post-surgery MRI staging (3 vs 4 vs 5), skull base location (yes vs no), age (< 60 vs ≥ 60), and participating center. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo observation only.
- Arm II: Within 4-7 months after surgery, patients undergo conventional fractionated radiotherapy once daily, 5 days a week for 6 weeks OR a single treatment of high-dose radiosurgery in the absence of unacceptable toxicity.
Quality of life is assessed at baseline, at 6 months after randomization, and then annually thereafter.
After completion of study treatment, patients are followed at 3 and 6 months after randomization and then annually thereafter.
PROJECTED ACCRUAL: A total of 478 patients (239 per treatment arm) will be accrued for this study within 3-4 years.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically confirmed newly diagnosed benign intracranial meningioma
- WHO grade I
- Any location except orbital meningioma
- Mitotic index < 4 (total counts per 10 high-power field) AND MIB-1 labeling index < 4%
The following histologies are not allowed (i.e., WHO grade II or III):
- Atypical
- Clear cell
- Choroid
- Rhabdoid
- Papillary
- Anaplastic
Must have undergone non-radical resection* within the past 7 months
- Post-operative MRI (performed 4 months after surgery) demonstrating stages 3, 4, or 5 NOTE: *Biopsy only is considered non-radical resection and may be classified as stage 4 or 5 according to tumor volume
- No brain invasion
- No hemangiopericytoma
- No fibrous dysplasia or intra-osseous meningioma
- No multiple meningiomas or meningiomatosis
- Not part of neurofibromatosis type II
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- WHO 0-2
Life expectancy
- Not specified
Hematopoietic
- Not specified
Hepatic
- Not specified
Renal
- Not specified
Cardiovascular
- No serious congestive heart failure
Other
- HIV negative
- No other malignancy except basal cell skin cancer or carcinoma in situ of the cervix
- No other disease that would preclude 5-year follow up after study completion
- No psychological, familial, sociological, or geographical condition that would preclude study compliance or study follow up
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- Not specified
Endocrine therapy
- Not specified
Radiotherapy
- No prior radiotherapy to the meninges or brain that would preclude study treatment
Surgery
- See Disease Characteristics
Other
- No prior randomization to this study
Contacts and Locations| Germany | |
| University Hospital Schleswig-Holstein - Kiel Campus | |
| Kiel, Germany, D-24105 | |
| Netherlands | |
| Radiotherapeutisch Instituut-(Riso) | |
| Deventer, Netherlands, 7400 AC | |
| University Medical Center Rotterdam at Erasmus Medical Center | |
| Rotterdam, Netherlands, 3000 CA | |
| Switzerland | |
| Hopital Cantonal Universitaire de Geneve | |
| Geneva, Switzerland, CH-1211 | |
| Study Chair: | John G. Wolbers, MD, PhD | University Medical Center Rotterdam at Erasmus Medical Center |
| Study Chair: | Raymond Miralbell, MD | Hopital Cantonal Universitaire de Geneve |
| Study Chair: | Rolando F. Del Maestro, MD, PhD | Montreal Neurological Institute and Hospital |
| Study Chair: | Luis Souhami, MD | McGill Cancer Centre at McGill University |
More Information
Additional Information:
No publications provided
| Responsible Party: | European Organisation for Research and Treatment of Cancer - EORTC |
| ClinicalTrials.gov Identifier: | NCT00104936 History of Changes |
| Other Study ID Numbers: | EORTC-26021 -22021, EORTC-26021, EORTC-22021, CAN-NCIC-EORTC-26021 |
| Study First Received: | March 3, 2005 |
| Last Updated: | September 20, 2012 |
| Health Authority: | United States: Federal Government |
Keywords provided by European Organisation for Research and Treatment of Cancer - EORTC:
|
adult grade I meningioma |
Additional relevant MeSH terms:
|
Meningioma Nervous System Neoplasms Central Nervous System Neoplasms Neoplasms, Nerve Tissue Neoplasms by Histologic Type |
Neoplasms Neoplasms, Vascular Tissue Meningeal Neoplasms Neoplasms by Site Nervous System Diseases |
ClinicalTrials.gov processed this record on May 19, 2013