Radiotherapy versus Observation following surgical resection of Atypical Meningioma (the ROAM trial).

Atypical meningioma

Atypical (WHO Grade IImeningiomas comprise a heterogeneous group of tumors, with histopathology delineated under the guidance of the WHOand a spectrum of clinical outcomes.
Approximately 15-20% of meningiomas are atypical, meaning that the tumor cells do not appear typical or normal. Atypical meningiomas are neither malignant (cancerous) nor benign, but may become malignant. Grade II atypical meningiomas also tend to recur and grow faster.

Treatment

The role of postoperative radiotherapy for patients with atypical meningiomas who have undergone gross-total resection (GTR) remains unclear.
retrospective series supports the observation that postoperative radiotherapy likely results in lower recurrence rates of gross totally resected atypical meningiomas. Although a multicenter prospective trial will ultimately be needed to fully define the role of radiotherapy in managing gross totally resected atypical meningiomas 1)
1) Komotar RJ, Iorgulescu JB, Raper DM, Holland EC, Beal K, Bilsky MH, Brennan CW, Tabar V, Sherman JH, Yamada Y, Gutin PH. The role of radiotherapy following gross-total resection of atypical meningiomas. J Neurosurg. 2012 Oct;117(4):679-86. doi: 10.3171/2012.7.JNS112113. Epub 2012 Aug 24. PubMed PMID: 22920955.

Jenkinson MD, Weber DC, Haylock BJ, Mallucci CL, Zakaria R, Javadpour M.Radiotherapy versus Observation following surgical resection of Atypical Meningioma (the ROAM trial). Neuro Oncol. 2014 Jul 19. pii: nou149. [Epub ahead of print] PubMed PMID: 25038504.