With this post, SNOLA starts an educational project that will include short reviews on relevant articles in the practice of Neuro-Oncology.
We started the project with the IMPASSE study, a retrospective cohort of patients with incidental meningiomas diagnosed in 14 centers in 10 countries. A total of 727 patients who underwent radiosurgery (SRS) with a mean follow-up of 57.2 months and 388 patients who were conservatively followed for a mean time of 43.5 months were included in the analysis.
Local control with radiosurgery reached 99.0% versus 64.2% in active surveillance cases (p<.001), and the incidence of new neurological deficits was observed in 2.5% in the SRS group versus 2.8% in untreated patients. (p=.764). When the groups were balanced, using the propensity matching tool with elements of age, tumor volume, location and follow-up image, the results of local control and incidence of new neurological deficits maintained similar proportions between the two groups. Another interesting element observed was the tumor regression observed using RECIST in 44.4% of irradiated patients.
IMPASSE should not change the behavior of physicians inclined to observe (new neurological deficits in the 3.4% range) or to treat (significant local control without the addition of new neurological deficits). In any case, it is another reference in the context of decisions regarding the pathology.
Arthur Accioly Rosa is a radio-oncologist at Oncoclínicas Salvador, Second Secretary of SNOLA and former President of the Brazilian Society of Radiotherapy