Short course radiotherapy is an appropriate option for most malignant glioma patients

Lawrence R. Kleinberg, Tanya Slick, Cheryl Enger, Stuart Grossman, Henry Brem, Moody D. Wharam

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To determine whether a shortened course of radiotherapy (RT) is an appropriate treatment option for malignant glioma patients. Methods and Materials: Prognostic groups published by the Radiation Therapy Oncology Group (RTOG) are used to compare results for a short radiotherapy regimen with results of aggressive protocol treatment. The study group includes 219 patients treated during 1975-1993 with 51 Gy in 17 fractions. Patients were retrospectively assigned to six prognostic groups previously identified in o recursive partitioning analysis of the RTOG. The prognostic groups are based on age, histology, performance status, mental status, neurologic function, resection extent, length of symptoms, and RT dose. Results: The six RTOG prognostic groupings were significantly predictive of outcome for patients treated with this shortened regimen (log-rank, p < 0.001). The median survival for our patients by RTOG groups 1-6 were 68, 57, 22, 13, 8, and 5 months, respectively. Two-year survival results were 64, 67, 45, 8, 3, and 3%. The median and two-year survival results for each prognostic grouping were similar to the results achieved by aggressive treatment on RTOG malignant glioma trials for selected patients. Treatment toxicity was uncommon. Conclusion: This shortened regimen is an appropriate treatment option for most malignant glioma patients (RTOG groups 4-6), resulting in similar survival as standard regimens with reduced patient effort and cost. Although acute side effects are acceptable and the risk of brain necrosis is low, we do not recommend this treatment to the minority of patients who have a substantial long term survival probability (RTOG groups 13) because long term neurocognitive assessment is lacking.

Original languageEnglish (US)
Pages (from-to)31-36
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume38
Issue number1
DOIs
StatePublished - Apr 1 1997

Keywords

  • Anaplastic astrocytoma
  • Cost
  • Glioblastoma
  • Malignan glioma
  • Quality of life
  • Radiotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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