Adjuvant radiotherapy for atypical meningioma
Mené sur 990 patients atteints d’un méningiome atypique de grade 2 nouvellement diagnostiqué et traité par résection chirurgicale complète (durée médiane de suivi : 64 mois ; âge médian : 57,4 ans ; 46 % d'hommes), cet essai randomisé international de phase III évalue l'intérêt, du point de vue de la survie sans maladie, d'une radiothérapie adjuvante fractionnée avec modulation d'intensité
Surgical resection remains the mainstay of treatment for atypical meningiomas, corresponding to WHO grade 2 tumours, particularly given the substantial risk of recurrence after subtotal resection. Accordingly, adjuvant radiotherapy has been proposed as a means of reducing the risk of recurrence, and its role is relatively well accepted in patients with residual tumour. After gross total resection (defined as Simpson grade I–III), however, the rationale is less clear: 5-year progression-free survival with gross total resection alone is 67–86%, and the role of adjuvant radiotherapy remains controversial, with its benefit in disease control weighed against potential toxicities. Although several single-institutional studies have investigated the effect of adjuvant radiotherapy, their findings have been inconsistent. Since 2021, multicentre studies and meta-analyses have provided accumulating evidence supporting a potential role for adjuvant radiotherapy in improving tumour control following gross total resection.
The Lancet , commentaire, 2026