Radiation therapy quality assurance (RT QA) of adjuvant fractionated radiotherapy for WHO grade 2 atypical meningioma in the ROAM/EORTC1308 trial
5 affiliations
- 1The Clatterbridge Cancer Centre NHS Foundation Trust, Clatterbridge Road, Bebington, CH63 4JY, UK; National Radiotherapy Trials Quality Assurance (RTTQA) Group, UK; Corresponding author at: Five Oaks, Street Hey Lane, Willaston, CH64 1SS.7196, United Kingdom.
- 2The Clatterbridge Cancer Centre NHS Foundation Trust, Clatterbridge Road, Bebington, CH63 4JY, UK
- 3The Christie NHS Foundation Trust, 550 Wilmslow Road, Withington, Manchester, M20 4BX, UK
- 4Center for Proton Therapy, Paul Scherrer Institut, Switzerland
- 5The University of Liverpool, Liverpool, L69 7ZX, UK
Abstract
Introduction: ROAM/EORTC-1308 is an international (Europe and Australasia) phase III randomised controlled trial (RCT) comparing radiotherapy (60Gy/30#) to observation after surgery for WHO grade 2 atypical meningioma. The treatment plans of all the patients randomised to radiotherapy were reviewed and approved prior to treatment delivery. Pretrial credentialling included outlining and planning a benchmark case. Materials and methods: Variations from the guidelines were noted in QA reports both for the Benchmark Case (BM) and for on-trial Individual Case Reviews (ICRs). After the trial, the QA reports were used to analyse the variations in the BM and ICRs. A random 10% of the ICRs were reviewed again independently. In all cases the reviewer agreed with the original decision. Results: 58 centres opened, of which 56 centres (20 UK, 25 EORTC, 11 TROG) submitted BM. Two centres did not undergo radiotherapy credentialling and closed without recruiting any patients. Resubmissions were: 4 (7%) for outlining and 11 (20%) for planning. During the trial 66 patients at 28 centres received radiotherapy, (median 2 patients per site). Resubmissions for ICRs were: 31 (48%) sets of outlines (3 cases twice) and 12 (18%) treatment plans (1 plan twice). There were 28 instances of major variations in the ICR outlines and 14 in the ICR plans. Conclusions: For complex radiotherapy of uncommon tumours, a pre-trial QA is insufficient and prospective ICRs of all patients are required. The consistent high-quality radiotherapy in ROAM/EORTC1308 ensures the primary outcome is robust and that there was no variation in radiotherapy treatment across sites.
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BibTeX
@article{mayles2026radiation,
title = {{Radiation therapy quality assurance (RT QA) of adjuvant fractionated radiotherapy for WHO grade 2 atypical meningioma in the ROAM/EORTC1308 trial}},
author = {Helen M.O. Mayles and Brian J. Haylock and Gillian Whitfield and Shaveta Mehta and Alice Brain and Robert Brass and Damien C. Weber and Michael D. Jenkinson},
journal = {Clinical and Translational Radiation Oncology},
year = {2026},
month = oct,
doi = {10.1016/j.ctro.2026.101322},
url = {https://doi.org/10.1016/j.ctro.2026.101322},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Radiation therapy quality assurance (RT QA) of adjuvant fractionated radiotherapy for WHO grade 2 atypical meningioma in the ROAM/EORTC1308 trial
AU - Helen M.O. Mayles
AU - Brian J. Haylock
AU - Gillian Whitfield
AU - Shaveta Mehta
AU - Alice Brain
AU - Robert Brass
AU - Damien C. Weber
AU - Michael D. Jenkinson
PY - 2026
DA - 2026/10/20
JO - Clinical and Translational Radiation Oncology
DO - 10.1016/j.ctro.2026.101322
UR - https://doi.org/10.1016/j.ctro.2026.101322
AB - Introduction: ROAM/EORTC-1308 is an international (Europe and Australasia) phase III randomised controlled trial (RCT) comparing radiotherapy (60Gy/30#) to observation after surgery for WHO grade 2 atypical meningioma. The treatment plans of all the patients randomised to radiotherapy were reviewed and approved prior to treatment delivery. Pretrial credentialling included outlining and planning a benchmark case. Materials and methods: Variations from the guidelines were noted in QA reports both for the Benchmark Case (BM) and for on-trial Individual Case Reviews (ICRs). After the trial, the QA reports were used to analyse the variations in the BM and ICRs. A random 10% of the ICRs were reviewed again independently. In all cases the reviewer agreed with the original decision. Results: 58 centres opened, of which 56 centres (20 UK, 25 EORTC, 11 TROG) submitted BM. Two centres did not undergo radiotherapy credentialling and closed without recruiting any patients. Resubmissions were: 4 (7%) for outlining and 11 (20%) for planning. During the trial 66 patients at 28 centres received radiotherapy, (median 2 patients per site). Resubmissions for ICRs were: 31 (48%) sets of outlines (3 cases twice) and 12 (18%) treatment plans (1 plan twice). There were 28 instances of major variations in the ICR outlines and 14 in the ICR plans. Conclusions: For complex radiotherapy of uncommon tumours, a pre-trial QA is insufficient and prospective ICRs of all patients are required. The consistent high-quality radiotherapy in ROAM/EORTC1308 ensures the primary outcome is robust and that there was no variation in radiotherapy treatment across sites.
SN - 2405-6308
ER -