Journal Article

DKFZ-2026-00319

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Fractionated radiotherapy adjuvant to surgery of WHO-2 meningioma with and without gross total resection: a multicenter, retrospective cohort study of 1,452 patients.

Mirian, C. ; Jensen, L. R. ; Hoffmann, A. G. ; Juratli, T. A. ; Maier, A. D. ; Lindner, P. ; Broechner, A. ; Torp, S. H. ; Shih, H. A. ; Morshed, R. A. ; Young, J. S. ; Magill, S. T. ; Stummer, W. ; Spille, D. C. ; Brokinkel, B. ; Proescholdt, M. ; Kuroi, Y. ; Gousias, K. ; Simon, M. ; Prat-Acin, R. ; Goutagny, S. ; Wach, J. ; Güresir, E. ; Yamamoto, J. ; Kim, Y. Z. ; Lee, J. H. ; Kim, D. W. ; Koshy, M. ; Cannon, D. M. ; Shrieve, D. C. ; Suh, C.-O. ; Chang, J. H. ; Kamenova, M. ; Straumann, S. ; Soleman, J. ; Eyüpoglu, I. Y. ; Catalan, T. ; Lui, A. ; Theodosopoulos, P. V. ; McDermott, M. W. ; Góes, P. ; Wang, F. ; Souhami, L. ; Guiot, M.-C. ; Csonka, T. ; Endo, T. ; Gupta, T. ; Patel, A. J. ; Klisch, T. J. ; Kim, J. W. ; Maiuri, F. ; Barresi, V. ; Tabernero, M. D. ; Skyrman, S. ; Krause, M.DKFZ* ; Law, I. ; Kristensen, B. W. ; Munch, T. N. ; Meling, T. ; Fugleholm, K. ; Blanche, P. ; Mathiesen, T.

2026
Springer Science + Business Media B.V Dordrecht [u.a.]

Abstract: Purpose:The role of adjuvant fractionated radiotherapy (aFRT) after gross total resection (GTR) of WHO-2 meningiomas remains unclear. We aimed to estimate the effect of aFRT on recurrence risk and survival following GTR and subtotal resection (STR).Methods:We analyzed 1452 patients with WHO-2 from our international, multicenter database (followed between 1989 and 2019). Outcomes were recurrence (10-year follow-up) and death (5-year follow-up). Risk estimates were obtained using competing risks and survival analysis. Average treatment effects were estimated by G-computation, adjusted for potential confounding by age, sex, Simpson grade, Ki-67 proliferation index, location, country group (universal healthcare or not), and year of treatment initiation. The robustness of findings was examined through sensitivity analyses.Results:Overall, 276 of 1452 patients (19.0%) received aFRT. Among GTR patients, unadjusted analysis showed comparable recurrence proportions between irradiated and non-irradiated patients (25.5% vs. 22.8% within 5 years). Adjusted analyses provided no evidence that aFRT reduced the risk of recurrence (largest difference: −2.7%, 95% CI −5.6 to 0.2); although, the CIs include the possibility of small beneficial effects. In STR patients, aFRT was associated with reduced recurrence risk in both unadjusted and adjusted analyses. Unexpectedly, a higher mortality was observed among irradiated GTR patients, largely driven by older patients with low Ki-67 PI receiving aFRT. Sensitivity analyses showed similar results for patients with STR but discrepancy in estimates for those with GTR.Conclusion:Adjuvant FRT showed a consistent reduction in recurrence risk after STR while inconsistent recurrence risk estimates were observed for patients with GTR. The findings reflect efficacy of aFRT using real-world data without standardized guidelines.

Keyword(s): Atypical meningioma ; Meningioma ; Progression ; Radiotherapy ; Recurrence ; Resection

Note: #DKTKZFB26# / #NCTZFB26#

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Dresden (DD01)
2. Koordinierungsstelle NCT Dresden (DD04)
3. DKTK DD Translationale Radioonkologie (DD02)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2026

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DEAL Springer ; DEAL Springer ; Essential Science Indicators ; IF < 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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