Radiotherapy Reduces Recurrence Risk in Atypical Meningiomas: New Study Findings
Radiotherapy following complete surgical resection significantly lowers the recurrence rate of atypical meningiomas, according to international research published in September 2026 in The Lancet. Conducted across 58 hospitals in 11 countries, the ROAM/EORTC-1308 trial provides the first randomized clinical evidence establishing adjuvant radiotherapy as an effective strategy to improve disease-free survival for patients diagnosed with WHO grade 2 meningiomas.
- Trial Design: The international ROAM/EORTC-1308 trial evaluated 157 patients following complete surgical resection of an atypical meningioma.
- Recurrence Rates: After a median follow-up of five years, 11 out of 78 patients (14 per cent) in the radiotherapy group experienced a tumor recurrence, compared to 24 out of 79 patients (30 per cent) in the observation group.
- Survival Metrics: Five-year disease-free survival reached 79.9 percent for patients receiving radiotherapy, versus 64.3 percent for those under imaging surveillance alone.
Addressing the High Recurrence Risk in WHO Grade 2 Meningiomas
Meningiomas comprise roughly one-third of primary brain tumors in adults, originating in the meninges rather than arising from systemic metastases. Among these, atypical meningiomas carry a notably high risk of recurrence even when neurosurgeons achieve a complete surgical resection. Historically, clinical consensus lacked strong data from randomized trials regarding whether patients genuinely benefit from adding adjuvant radiotherapy immediately after surgery, leaving many clinicians to rely strictly on imaging surveillance.
The ROAM/EORTC-1308 trial set out to resolve this therapeutic uncertainty. Led by a team including Matthias Preusser at the Medical University of Vienna, alongside Michael Jenkinson and Carrol Gamble at the Liverpool Clinical Trials Centre, and Damien C. Weber at the Paul Scherrer Institute and Inselspital – University Hospital of Bern, the study enrolled 157 participants across Austria, Australia, Belgium, Ireland, France, Germany, New Zealand, Italy, Spain, Switzerland, and the United Kingdom.
Clinical Outcomes and Trial Methodology
Researchers randomized the 157 participants into two distinct management pathways following complete tumor removal. A cohort of 78 patients received 30 sessions of radiotherapy, while a control group of 79 patients underwent routine imaging surveillance. The findings demonstrate a clear divergence in clinical outcomes over a median follow-up period of approximately five years.
| Clinical Endpoint | Radiotherapy Group (n=78) | Observation Group (n=79) |
|---|---|---|
| Tumor Recurrence | 11 out of 78 patients (14 per cent) | 24 out of 79 patients (30 per cent) |
| 5-Year Disease-Free Survival | 79.9 percent | 64.3 percent |
According to Matthias Preusser, head of the Division of Oncology at the Department of Medicine I at the Medical University of Vienna, the trial provides the best available evidence supporting adjuvant radiotherapy. As a direct result of these findings, national and international clinical guidelines are set to incorporate the data. However, the study authors emphasize that treatment decisions must involve joint discussions with patients to weigh potential long-term side effects and radiation-related consequences against the reduced risk of tumor return, noting that serious adverse radiation events occurred rarely during the trial.
Future Trajectory and Clinical Implications
While the five-year data establish a clear advantage for immediate radiotherapy in terms of disease-free survival, ongoing research is required to evaluate long-term efficacy. Further investigations will examine whether the protective benefit of radiotherapy persists beyond the five-year window and how specific patient sub-populations respond to altered dosing schedules.
*Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.*