Malignant glioma grade 3 and 4: How relevant is timing of radiotherapy?

• Published in: Clinical neurology and neurosurgery 2012-07, Vol.114 (6), p.617-621
• Main Authors: Wehming, Friederike M, Wiese, Bettina, Nakamura, Makoto, Bremer, Michael, Karstens, Johann H, Meyer, Andreas
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Aged; Antineoplastic Agents - therapeutic use; Astrocytoma - diagnostic imaging; Biological and medical sciences; Brain cancer; Brain Neoplasms - radiotherapy; Brain Neoplasms - surgery; Brain tumor; Brain tumors; Chemotherapy; Cohort Studies; Combined Modality Therapy; Disease-Free Survival; Female; Follow-Up Studies; Glioblastoma - radiotherapy; Glioma; Glioma - radiotherapy; Glioma - surgery; Humans; Male; Malignant glioma; Medical sciences; Medical treatment; Middle Aged; Multivariate Analysis; Neurology; Neurosurgery; Neurosurgical Procedures; Oligodendroglioma - diagnostic imaging; Overall treatment time; Prognosis; Radiation therapy; Radiography; Radiotherapy; Statistical analysis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival; Survival Analysis; Time Factors; Treatment delay; Treatment Outcome; Tumors; Young Adult
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2011.12.024

Abstract Aims and background The aim of this study is to determine prognostic factors that influence further outcome in patients with glioma. Methods Between 01/2002 and 08/2008, 153 patients with malignant gliomas of WHO-grade 3 or 4 who were treated with external beam radiotherapy with or without chemotherapy. Results In univariate analysis, following factors were ascertained as statistically significant prognostic parameters: grade ( p = 0.000), time between operation and radiotherapy >24 days ( p = 0.044) for progression-free survival; grade ( p = 0.000), age < 58 years ( p = 0.001), extent of surgery ( p = 0.011), time between operation and radiotherapy >24 days ( p = 0.009), overall treatment time >68 days ( p = 0.003), use of chemotherapy ( p = 0.015) for overall survival. A longer time period between resection and start of radiotherapy showed to be associated with improved outcome. After multivariate analysis, only grade ( p = 0.000) remained a statistically significant factor for progression-free and grade ( p = 0.000) and use of chemotherapy ( p = 0.031) for overall survival. Conclusions We were able to recognize grade and use of chemotherapy as statistically significant prognostic determinants, but not time intervals or overall treatment time.