Impact of 1p/19q Codeletion and Histology on Outcomes of Anaplastic Gliomas Treated With Radiation Therapy and Temozolomide
| Autor: | Clifford G. Robinson, Todd DeWees, Christina K. Speirs, Michael R. Chicoine, Joseph R. Simpson, David Tran, Keith M. Rich, Jiayi Huang, Gregory J. Zipfel, Gerry Linette, Ralph G. Dacey, Eric C. Leuthardt, Albert H. Kim, Joshua L. Dowling |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty 1p/19q Codeletion Procarbazine Young Adult Risk Factors Internal medicine Antineoplastic Combined Chemotherapy Protocols Prevalence Temozolomide medicine Humans Genetic Predisposition to Disease Radiology Nuclear Medicine and imaging Anaplastic Oligoastrocytoma Antineoplastic Agents Alkylating Survival rate Aged Retrospective Studies Missouri Radiation Performance status Brain Neoplasms business.industry Radiotherapy Dosage Chemoradiotherapy Glioma Lomustine Middle Aged medicine.disease Dacarbazine Survival Rate Treatment Outcome Chromosomes Human Pair 1 Female Chromosome Deletion business Nuclear medicine Chromosomes Human Pair 19 Gene Deletion Anaplastic astrocytoma medicine.drug |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 91:268-276 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2014.10.027 |
| Popis: | Purpose Anaplastic gliomas represent a heterogeneous group of primary high-grade brain tumors, and the optimal postoperative treatment remains controversial. In this report, we present our institutional data on the clinical outcomes of radiation therapy (RT) plus temozolomide (RT + TMZ) for anaplastic gliomas, stratified by histology and 1p/19q codeletion. Methods and Materials A single-institution retrospective review was conducted of patients with supratentorial anaplastic oligodendroglioma (AO), mixed anaplastic oligoastrocytoma (AOA), and anaplastic astrocytoma (AA). After surgery, RT was delivered at a median total dose of 60 Gy (range, 31.6-63 Gy) in daily fractions. All patients received standard concurrent TMZ, with or without adjuvant TMZ. Histological/molecular subtypes were defined as codeleted AO/AOA, non-codeleted AO/AOA, and AA. Results From 2000 to 2012, 111 cases met study criteria and were evaluable. Codeleted AO/AOA had superior overall survival (OS) to non-codeleted AO/AOA (91% vs 68% at 5 years, respectively, P =.02), whereas progression-free survival (PFS) was not significantly different (70% vs 46% at 5 years, respectively, P =.10). AA had inferior OS to non-codeleted AO/AOA (37% vs 68% at 5 years, respectively, P =.007) and inferior PFS (27% vs 46%, respectively, P =.03). On multivariate analysis, age, performance status, and histological or molecular subtype were independent predictors for both PFS and OS. Compared to historical controls, RT + TMZ provided comparable OS to RT with procarbazine, lomustine, and vincristine (RT + PCV) for codeleted AO/AOA, superior OS to RT alone for non-codeleted AO/AOA, and similar OS to RT alone for AA. Conclusions RT + TMZ may be a promising treatment for both codeleted and non-codeleted AO/AOA, but its role for AA remains unclear. |
| Databáze: | OpenAIRE |
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