The use and efficacy of chemotherapy and radiotherapy in children and adults with pilocytic astrocytoma

Autor: Lindsay M. Burt, Nicholas S Whipple, Matthew M. Poppe, M.W. Parsons, Donald M. Cannon, Joe S Mendez
Rok vydání: 2020
Předmět:
Zdroj: Journal of Neuro-Oncology. 151:93-101
ISSN: 1573-7373
0167-594X
DOI: 10.1007/s11060-020-03653-y
Popis: The aim of this study was to understand the use of chemotherapy (CMT) and radiotherapy (RT) in pilocytic astrocytoma (PA) and their impact on overall survival (OS). Data from the National Cancer Database (NCDB) for patients with non-metastatic WHO grade I PA from 2004 to 2014 were analyzed. Pearson’s chi-squared test and multivariate logistic regression analyses were performed to assess the distribution of demographic, clinical, and treatment factors. Inverse probability of treatment weighting (IPTW) was used to account for differences in baseline characteristics. Kaplan–Meier analyses and doubly-robust estimation with multivariate Cox proportional hazards modeling were used to analyze OS. Of 3865 patients analyzed, 294 received CMT (7.6%), 233 received RT (6.0%), and 42 (1.1%) received both. On multivariate analyses, decreasing extent of surgical resection was associated with receipt of both CMT and RT. Brainstem tumors were associated with RT, optic nerve tumors were associated with CMT. Cerebellar tumors were inversely associated with both CMT and RT. Younger age was associated with receipt of CMT; conversely, older age was associated with receipt of RT. After IPTW, receipt of CMT and/or RT were associated with an OS decrement compared with matched patients treated with surgery alone or observation (HR 3.29, p
Databáze: OpenAIRE
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