This randomized phase III trial studies how well radiation therapy works compared with observation in treating patients with newly diagnosed grade II meningioma that has been completely removed by surgery. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors.
I. To determine the extent of clinical benefit of the addition of adjuvant radiotherapy (RT) to gross total resection (GTR) for patients with newly diagnosed World Health Organization (WHO) grade II meningioma.
I. Overall survival (OS).
II. Disease-specific survival (DSS).
III. Toxicity (grade 3+, exclusive of expected alopecia).
IV. Neurocognitive function (NCF).
V. Outcomes and patient reported outcomes (PRO) measurements.
VI. Adherence to protocol-specific target and normal tissue parameters.
VII. Concordance measurements of central versus parent-institution pathology.
VIII. Tissue microarray construction, and assessment of pHH3 mitotic index and molecular correlates to progression-free survival (PFS) and OS.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients undergo observation.
ARM II: Patients undergo radiation therapy 5 days a week over 6.5-7 weeks for a total of 33 fractions.
After completion of study treatment, patients are followed up at 3, 6, and 12 months, every 6 months for year 2 and 3, then yearly for 10 years.