TY - JOUR
T1 - Postoperative radiotherapy of adult supratentorial high-grade astrocytoma
AU - Chen, Shang Wen
AU - Jung, Shih Ming
AU - Lin, Fan Jen
AU - Tseng, Chen Kan
AU - Chen, Wen Cheng
AU - Chang, Joseph Tung Chieh
AU - Hong, Ji Hong
PY - 1999/2
Y1 - 1999/2
N2 - To find the prognostic factors of high grade glioma patients treated by postoperative radiotherapy. From 1979 through 1988, 79 patients with proven supratentorial high-grade astrocytoma completed external beam irradiation at Chang Chung Memorial Hospital following surgery, including by total removal (27 patients); subtotal removal (32 patients) or biopsy only (20 patients). Thirty-one patients and 48 (60.8%) patients had Kernohan grade III tumors and Glioblastoma multiform, respectively. There were 56 male (70.9%) and 23 female patients. Median age at time of diagnosis was 40 years (range, 15 to 69 years). The patients were subject to univariate and multivariate analyses according to age, sex, Kernohan grading, extent of surgery, treatment modality, and irradiation dose. Overall 2-year survival was 15% and median survival was 46 weeks. Improved survival were much more likely in patients younger than 40 years (p=0.016), with Kernohan grade III tumors (p=0.002), and those who underwent surgical excision (p=0.001). Multiple daily fractionation (30 patients) did not lengthen patient survival when compared with conventional radiotherapy (49 patients). For the 49 patients treated with conventional radiotherapy, the dose appeared to be associated with lengthened survival (p=0.037). Multivariate analysis using Cox's proportional hazard model for the 49 patients treated using conventional therapy showed Kernohan grade, extent of surgery, and irradiation dose were independent prognostic factors. Tumor pathological grade, extent of surgery and radiation dose were important prognostic factors in patients with high-grade astrocytoma. More extensive surgery and higher postoperative radiation dose lengthened the survival in patients with high-grade astrocytoma.
AB - To find the prognostic factors of high grade glioma patients treated by postoperative radiotherapy. From 1979 through 1988, 79 patients with proven supratentorial high-grade astrocytoma completed external beam irradiation at Chang Chung Memorial Hospital following surgery, including by total removal (27 patients); subtotal removal (32 patients) or biopsy only (20 patients). Thirty-one patients and 48 (60.8%) patients had Kernohan grade III tumors and Glioblastoma multiform, respectively. There were 56 male (70.9%) and 23 female patients. Median age at time of diagnosis was 40 years (range, 15 to 69 years). The patients were subject to univariate and multivariate analyses according to age, sex, Kernohan grading, extent of surgery, treatment modality, and irradiation dose. Overall 2-year survival was 15% and median survival was 46 weeks. Improved survival were much more likely in patients younger than 40 years (p=0.016), with Kernohan grade III tumors (p=0.002), and those who underwent surgical excision (p=0.001). Multiple daily fractionation (30 patients) did not lengthen patient survival when compared with conventional radiotherapy (49 patients). For the 49 patients treated with conventional radiotherapy, the dose appeared to be associated with lengthened survival (p=0.037). Multivariate analysis using Cox's proportional hazard model for the 49 patients treated using conventional therapy showed Kernohan grade, extent of surgery, and irradiation dose were independent prognostic factors. Tumor pathological grade, extent of surgery and radiation dose were important prognostic factors in patients with high-grade astrocytoma. More extensive surgery and higher postoperative radiation dose lengthened the survival in patients with high-grade astrocytoma.
KW - Brain neoplasm
KW - High-grade astrocytoma
KW - Prognostic factors
KW - Radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=0033035794&partnerID=8YFLogxK
M3 - 文章
AN - SCOPUS:0033035794
SN - 1018-8940
VL - 24
SP - 15
EP - 20
JO - Chinese Journal of Radiology
JF - Chinese Journal of Radiology
IS - 1
ER -