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What dose and volumes do you use for incompletely resected WHO grade II meningiomas with brain invasion?

Several articles report results with 0.5 -1 cm margins, and have suggested that with improved imaging and treatment planning, smaller margins such as those used by the EORTC are also appropriate for GTV to CTV expansion. The 2 cm expansions used in RTOG 0539 may result in much larger volumes of normal brain exposed to radiation. Is it therefore reasonable to treat patients with larger Simpson Grade 4, subtotally resected Grade II meningioma, with a 1 cm GTV to CTV expansion? Articles: Combs et al., PMID 33309848 Press et al., PMID 24661652 Rogers et al., PMID 31786276 Weber et al., PMID 29960684
2 Answers
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Radiation Oncology · GammaWest Cancer Services
Answered on

I agree with Dr. @Dr. First Last and find his approach both reasonable and wise. Permit me to review variations in target volume definition between the RTOG-0539 and NRG BN003 trials, and explain how I have approached patients with incompletely resected WHO grade II meningioma with brain invasion.

Th...

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Mednet Member
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Radiation Oncology · Columbia University Irving Medical Center
Answered on

In general, I try to follow RTOG 0539 contouring guidelines. That being said, I have at times reduced my margins to 1 cm even in subtotally resection grade II meningiomas. As the articles suggested, it appears to be a reasonable option. Would be nice to do a survey on practice patterns/margins from ...

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