Radiotherapy halves the risk of brain tumour returning after surgery, major UK-led trial finds
Results from the ROAM/EORTC-1308 trial could change treatment for patients with atypical meningioma.
Giving radiotherapy after surgery for a type of brain tumour called atypical meningioma can halve the risk of the tumour returning, according to results from a major international clinical trial, led by The Walton Centre and the University of Liverpool, called ROAM (Radiation versus Observation following surgical resection of Atypical Meningioma).
Findings from the ROAM/EORTC-1308 trial, presented at the 21st Annual Meeting of the European Association of Neuro-Oncology (EANO 2026) and published in The Lancet today, provide the strongest evidence to date that patients with completely resected atypical meningioma should be offered radiotherapy rather than observation alone.
Meningiomas are the commonest primary brain tumour and up to 2000 people undergo surgery each year in the UK. Atypical meningiomas account for around a quarter of meningioma and they are more likely to return than lower grade meningiomas. Until now, there has been uncertainty about whether patients should receive radiotherapy immediately after surgery or instead be monitored with regular brain scans and treated if the tumour comes back.
ROAM/EORTC-1308 is the first randomised controlled trial evaluating the role of radiotherapy compared to observation for reducing the risk of recurrence in patients who have undergone complete resection of atypical meningioma.
Between 2016 and 2021, 157 patients were randomly assigned to receive either radiotherapy or observation following complete surgical removal of their tumour. After a median five-year follow-up, 35 participants had their brain tumour recur - 14% in the radiotherapy group and 30% in the observation group. At five years, ~80% of patients who received radiotherapy remained free of recurrence, compared with ~60% of those who underwent observation. There were also no differences between the groups in terms of health-related quality of life and neurocognitive function, and there was minimal serious radiation-toxicity.
At the annual EANO meeting today (25/09/2026), the study was awarded 'EANO Best Oral Presentation for Clinical Research'.
Chief investigator and first author, Neurosurgeon Professor Michael Jenkinson, The Walton Centre NHS Foundation Trust in Liverpool, and RCS England/Sir John Fisher Foundation Chair of Surgical Trials the at the University of 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 decisions. Winning this award is a real honour and recognition of the many patients, investigators and collaborators who made the trial possible.”
“I work in neuro-oncology because brain tumours remain a major challenge for patients, families and clinicians, with many important questions still unanswered. I am motivated by the opportunity to work with patients and colleagues to turn those unanswered questions into research that can genuinely improve treatment and outcomes. For me, the most rewarding part is seeing research move from an idea into evidence that can change clinical practice and enable the next generation of neuro-oncology researchers.”
Professor of Radiation Oncology and radiotherapy co-lead for the trial, Professor Damien Weber 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 returning.”
“These results are important for patients and clinicians because recurrence can mean further surgery, further treatment and considerable anxiety. Our findings should now inform discussions about treatment following complete resection of an atypical meningioma.”
ROAM/EORTC-1308 was carried out in 11 countries across the world and 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 the Trans Tasman Radiation Oncology Group (TROG Cancer Research).
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. The trial was coordinated and analysed by the Liverpool Clinical Trials Centre (LCTC) at University of Liverpool.
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Notes to editors
Further information, or to arrange an interview, please contact the Communications Team at The Walton Centre on 0151 556 3397 or wcft.communications@nhs.net
The Walton Centre NHS Foundation Trust is the only hospital trust in the UK specialising in neurology, neurosurgery and pain services. Although the majority of patients come from Merseyside, Cheshire, North Wales, Lancashire and the Isle of Man, for some specialist treatments of complex disorders we see patients from all parts of the country, referred by their GPs or other neurologists, neurosurgeons and pain clinicians.
The Walton Centre NHS Foundation Trust was rated as 'Outstanding' by the Care Quality Commission. The independent regulator of all health and social care services in England published its rating on Friday 21 October 2016, following announced and unannounced inspection visits to the Trust in April 2016.
For more information please visit: www.thewaltoncentre.nhs.uk or follow the Trust on Twitter, Facebook or Instagram.
The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool L9 7LJ, 0151 525 3611