LATEST NEWS: 26 September 2026
Giving radiotherapy after surgery for atypical meningioma brain cancer can halve the risk of the tumour recurring, according to new findings from a major international trial on which TROG collaborated.
The findings from the EORTC 13.08 /TROG 15.02 ROAM trial were published in esteemed medical journal, The Lancet, and presented at the European Association of Neuro-Oncology (EANO 2026) annual meeting in Rome, Italy, this week, where the presentation was also awarded EANO Best Oral Presentation for Clinical Research.
Meningiomas are the most common type of primary tumour, and atypical meningiomas are more likely to recur than lower grade meningiomas. However, until now, there’s been uncertainty about whether patients should receive radiation therapy immediately after surgery to remove the tumour or should instead be monitored with regular brain scans and treated if the tumour returns.
The ROAM study was the first randomised controlled trial to investigate the role of radiation therapy compared to observation for reducing the risk of recurrence in patients who have undergone surgical removal of atypical meningioma.
Between 2016 and 2021, 157 patients across 58 hospitals and cancer centres in 11 countries were randomly assigned to receive either radiation therapy or observation after undergoing surgery to completely remove their tumour.
TROG ran the local arm of the trial, recruiting 15 participants from centres across Australia and New Zealand, initially led by Dr Gail Ryan and then by Dr Neda Haghighi, both from Peter MacCallum Cancer Centre.
After a median five-year follow-up, 14% of all participants in the radiation therapy group had their brain tumour recur, compared with 30% in those in the observation group, the new findings show.
After five years, almost 80% of patients who received radiation therapy remained free of tumour recurrence, compared with 64% of those who underwent observation. There were no differences between the groups in terms of health-related quality of life and neurocognitive function, and there was minimal serious radiation toxicity.
The ROAM trial was a collaboration between the University of Liverpool, The Walton Centre NHS Foundation Trust in the UK, the European Organisation for Research and Treatment of Cancer (EORTC) and TROG Cancer Research.
Evidence to inform future practice
Chief Investigator, Neurosurgeon Professor Michael Jenkinson from The Walton Centre NHS Foundation Trust in Liverpool, said: “The trial tackles a question that has been debated for many years: whether patients with atypical meningioma should receive radiotherapy after surgery. I’m proud that our team has been able to generate robust evidence that can help patients and clinicians make better-informed decision.”
Prof Jenkinson, who is also RCS England/Sir John Fisher Foundation Chair of Surgical Trials at the University of Liverpool, added: “Winning this award [for the presentation] is a real honour and recognition of the many patients, investigators and collaborators who made the trial possible.”
Co-lead for the trial, Professor Damien Weber, Professor of Radiation Oncology at the Paul Scherrer Institute in PSI Villigen Switzerland, said:
“For many years there has been genuine uncertainty about whether patients with atypical meningioma should have radiotherapy after surgery or be monitored. ROAM provides the first randomised evidence that early radiotherapy substantially reduces the risk of the tumour recurring.”
The paper concluded that adjuvant radiotherapy should be considered in patients with atypical meningioma after complete surgical resection, based on individual discussion with the patient.
Congratulations to the researchers in Australia and internationally on these important trial findings, which have potential to change the way this type of brain cancer is managed and to improve outcomes for patients.
The study was funded by the National Institute for Health and Care Research Health Technology Assessment Programme (NIHR-HTA), the EORTC Brain Tumour Group and Radiation Oncology Group and the National Health and Medical Research Council of Australia (NHMRC).
- Read the paper in The Lancet