Effect of the addition of chemotherapy to radiotherapy on cognitive function in patients with low-grade glioma

Secondary analysis of RTOG 98-02

Roshan S. Prabhu, Minhee Won, Edward G. Shaw, Chen Hu, David G. Brachman, Jan C. Buckner, Keith J. Stelzer, Geoffrey R. Barger, Paul D. Brown, Mark R. Gilbert, Minesh P. Mehta

Research output: Contribution to journalArticle

Abstract

Purpose: The addition of PCV (procarbazine, lomustine, and vincristine) chemotherapy to radiotherapy (RT) for patients with WHO grade 2 glioma improves progression-free survival (PFS). The effect of therapy intensification on cognitive function (CF) remains a concern in this population with substantial long-term survival. Patients and Methods: A total of 251 patients with WHO grade 2 glioma age ≥ 40 years with any extent of resection or age <40 years with subtotal resection/biopsy were randomly assigned to RT (54 Gy) or RT plus PCV. We observed 111 patients age <40 years with gross total resection. CF was assessed by Mini-Mental State Examination (MMSE) at baseline and years 1, 2, 3, and 5. Results: Overall, few patients experienced significant decline in MMSE score. There were no significant differences in the proportion of patients experiencing MMSE score decline between the randomized study arms at any time point. Both study arms experienced a significant gain in average MMSE score longitudinally over time, with no difference between arms. Conclusion: The MMSE is a relatively insensitive tool, and subtle changes in CF may have been missed. However, the addition of PCV to RT did not result in significantly higher rates of MMSE score decline than RT alone through 5 years of follow-up. Patients in both randomly assigned arms experienced a statistically significant average MMSE score increase over time, with no difference between arms. The addition of PCV chemotherapy to RT improves PFS without excessive CF detriment over RT alone for patients with low-grade glioma.

Original languageEnglish (US)
Pages (from-to)535-541
Number of pages7
JournalJournal of Clinical Oncology
Volume32
Issue number6
DOIs
StatePublished - Feb 20 2014
Externally publishedYes

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Glioma
Cognition
Radiotherapy
Drug Therapy
Disease-Free Survival
Lomustine
Procarbazine
Vincristine
Biopsy
Survival
Population

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Effect of the addition of chemotherapy to radiotherapy on cognitive function in patients with low-grade glioma : Secondary analysis of RTOG 98-02. / Prabhu, Roshan S.; Won, Minhee; Shaw, Edward G.; Hu, Chen; Brachman, David G.; Buckner, Jan C.; Stelzer, Keith J.; Barger, Geoffrey R.; Brown, Paul D.; Gilbert, Mark R.; Mehta, Minesh P.

In: Journal of Clinical Oncology, Vol. 32, No. 6, 20.02.2014, p. 535-541.

Research output: Contribution to journalArticle

Prabhu, RS, Won, M, Shaw, EG, Hu, C, Brachman, DG, Buckner, JC, Stelzer, KJ, Barger, GR, Brown, PD, Gilbert, MR & Mehta, MP 2014, 'Effect of the addition of chemotherapy to radiotherapy on cognitive function in patients with low-grade glioma: Secondary analysis of RTOG 98-02', Journal of Clinical Oncology, vol. 32, no. 6, pp. 535-541. https://doi.org/10.1200/JCO.2013.53.1830
Prabhu, Roshan S. ; Won, Minhee ; Shaw, Edward G. ; Hu, Chen ; Brachman, David G. ; Buckner, Jan C. ; Stelzer, Keith J. ; Barger, Geoffrey R. ; Brown, Paul D. ; Gilbert, Mark R. ; Mehta, Minesh P. / Effect of the addition of chemotherapy to radiotherapy on cognitive function in patients with low-grade glioma : Secondary analysis of RTOG 98-02. In: Journal of Clinical Oncology. 2014 ; Vol. 32, No. 6. pp. 535-541.
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AU - Prabhu, Roshan S.

AU - Won, Minhee

AU - Shaw, Edward G.

AU - Hu, Chen

AU - Brachman, David G.

AU - Buckner, Jan C.

AU - Stelzer, Keith J.

AU - Barger, Geoffrey R.

AU - Brown, Paul D.

AU - Gilbert, Mark R.

AU - Mehta, Minesh P.

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