Survival, prognostic factors, and therapeutic efficacy in low-grade glioma: a retrospective study in 379 patients
| Autor: | Jon Berg-Johnsen, Bjarne Hager, Beth Stenwig, Knut Lote, Ingebjerg Storm-Mathisen, Henry Hirschberg, Kari Skullerud, Thore Egeland |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent medicine.medical_treatment Risk Factors Glioma Internal medicine medicine Humans Infusions Intra-Arterial Child Antineoplastic Agents Alkylating Survival analysis Aged Proportional Hazards Models Retrospective Studies Carmustine Chemotherapy Performance status business.industry Proportional hazards model Brain Neoplasms Infant Retrospective cohort study Radiotherapy Dosage Middle Aged medicine.disease Prognosis Combined Modality Therapy Survival Analysis Confidence interval Surgery Treatment Outcome Oncology Child Preschool Female business medicine.drug |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 15(9) |
| ISSN: | 0732-183X |
| Popis: | PURPOSE We report survival, prognostic factors, and treatment efficacy in low-grade glioma. PATIENTS AND METHODS A total of 379 patients with histologic intracranial low-grade glioma received post-operative radiotherapy (n = 361) and intraarterial carmustine (BCNU) chemotherapy (n = 153). Overall survival and prognostic factors were evaluated with the SPSS statistical program (SPSS Inc, Chicago, IL). RESULTS Median survival (all patients) was 100 months (95% confidence interval [CI], B7 to 113); in age group 0 to 19 years (n = 41), 226 months; in age group 20 to 49 years (n = 263), 106 months; in age group 50 to 59 years (n = 49), 76 months; and for older patients (n = 26), 39 months. Projected survival at 10 and 15 years was 42% and 29%, respectively. Patient age, World Health Organization (WHO) performance status, tumor computed tomography (CT) contrast enhancement, mental changes, or initial corticosteroid dependency were significant independent prognostic factors (p < .05), while histologic subgroup, focal deficits, presence of seizures, prediagnostic symptom duration, tumor category, and tumor stage were not. Patients aged 20 to 49 years with no independent negative prognostic factors (n = 132) had a median survival time of 139 months versus 41 months in patients with two or more factors (n = 33). Patients who presented with symptoms of expansion (n = 97) survived longer when resected (P < .03); otherwise no survival benefit was associated with initial tumor resection compared with biopsy. Intraarterial chemotherapy and radiation doses more than 55 Gy were not associated with prolonged survival. Among 66 reoperated patients, 45% progressed to high-grade histology within 25 months. CONCLUSION Prognosis in low-grade glioma following postoperative radiotherapy seems largely determined by the inherent biology of the glioma and patient age at diagnosis. |
| Databáze: | OpenAIRE |
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