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AWT IMAGE

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:: Volume 21, Issue 1 (1-2023) ::
Int J Radiat Res 2023, 21(1): 139-145 Back to browse issues page
Postoperative intensity-modulated radiotherapy and chemotherapy in patients with high-grade glioma: analysis of efficacy and prognostic factors
H. Zhu , J. Luo
Department of Radiotherapy, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou Medical Center, Nanjing Medical University, Changzhou, 213003, China , judongluo@163.com
Abstract:   (762 Views)
Background: To determine the treatment efficacy and prognostic factors for high-grade glioma (HGG) patients treated with postoperative intensity-modulated radiotherapy (IMRT). Materials and Methods: An analysis of 86 HGG patients who underwent surgery, radiotherapy (total dose: 54-60 Gy), and chemotherapy was performed retrospectively. The primary endpoint was Overall survival (OS), while the secondary endpoint was progression-free survival (PFS). Patient factors, tumor characteristics, and treatments were examined for their prognostic value. Results: Among the enrolled patients, there were 22 patients of grade III and 64 patients of grade IV. At the end of the study, 48 cases had died, and 66 cases had relapsed. The median OS was 24 months, while the median PFS was just 9 months. The mean OS of patients with grade III and IV glioma was 41 months and 16 months, respectively. Patients had relative survival rates of 73.2%, 46.6%, and 27.0% at 1, 2, and 5 years. The most common type of tumor recurrence was relapse within the radiation field. Univariate analysis indicated that sex, age, Karnofsky Performance Scale score (KPS), Pathological grade, tumor location, surgical approach, and adjuvant chemotherapy cycles were predictive factors for OS (P< 0.05). In contrast, sex, age, pathological grade, number of lesions, surgical approach, and adjuvant chemotherapy cycles were predictive factors for PFS (P < 0.05). According to multivariate analysis indicated that pathological grade, surgical approach, and adjuvant chemotherapy cycles were associated with longer OS and PFS (P< 0.05). Conclusions: Grade III gliomas, total surgical resection, and adjuvant chemotherapy for more than six cycles were associated with more favorable survival outcomes in this study.
Keywords: High-grade glioma, radiotherapy, chemotherapy, prognostic factors, survival analysis.
Full-Text [PDF 760 kb]   (742 Downloads)    
Type of Study: Original Research | Subject: Radiation Biology
References
1. Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. (2016) The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol, 131(6): 803-20. [DOI:10.1007/s00401-016-1545-1] [PMID]
2. Chinese central nervous system glioma diagnosis and treatment guidelines writing group. (2016) Guidelines for the diagnosis and treatment of central nervous system gliomas in China(2015). Natl Med J China, 96(7): 485-509.
3. Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJB, Janzer RC, et al. (2009) Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. The Lancet Oncology, 10(5): 459-66. [DOI:10.1016/S1470-2045(09)70025-7]
4. Liang J, Lv X, Lu C, Ye X, Chen X, Fu J, et al. (2020) Prognostic factors of patients with Gliomas - an analysis on 335 patients with Glioblastoma and other forms of Gliomas. BMC Cancer, 20(1): 35. [DOI:10.1186/s12885-019-6511-6] []
5. Hong JB, Roh TH, Kang SG, Kim SH, Moon JH, Kim EH, et al. (2020) Survival, prognostic factors, and volumetric analysis of extent of resection for anaplastic gliomas. Cancer Res Treat, 52(4): 1041-49. [DOI:10.4143/crt.2020.057] [PMID] []
6. Zhou X, Niu X, Mao Q, Liu Y (2020) Clinical significance of various classification standards of age groups in predicting survival of patients with glioblastoma. Med Sci Monit, 26: e920627. [DOI:10.12659/MSM.920627] []
7. Sun Y, Xiong ZY, Yan PF, Jiang LL, Nie CS, Wang X (2019) Characteristics and prognostic factors of age-stratified high-grade intracranial glioma patients: A population-based analysis. Bosn J Basic Med Sci, 19(4): 375-83. [DOI:10.17305/bjbms.2019.4213] []
8. Tian M, Ma W, Chen Y, Yu Y, Zhu D, Shi J, et al. (2018) Impact of gender on the survival of patients with glioblastoma. Biosci Rep, 38(6): 1-12. [DOI:10.1042/BSR20180752] [PMID] []
9. Trifiletti DM, Alonso C, Grover S, Fadul CE, Sheehan JP, Showalter TN (2017) Prognostic implications of extent of resection in glioblastoma: Analysis from a Large database. World Neurosurg, 103: 330-40. [DOI:10.1016/j.wneu.2017.04.035]
10. Coomans M, Dirven L, N KA, Baumert BG, van den Bent M, Bottomley A, et al. (2019) The added value of health-related quality of life as a prognostic indicator of overall survival and progression-free survival in glioma patients: a meta-analysis based on individual patient data from randomised controlled trials. Eur J Cancer, 116: 190-98. [DOI:10.1016/j.ejca.2019.05.012] [PMID]
11. Wen PY, Macdonald DR, Reardon DA, Cloughesy TF, Sorensen AG, Galanis E, et al. (2010) Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol, 28(11): 1963-72. [DOI:10.1200/JCO.2009.26.3541]
12. Caruso C, Carcaterra M, Donato V (2013) Role of radiotherapy for high grade gliomas management. J Neurosurg Sci, 57(2): 163-9.
13. Shin JY and Diaz AZ (2016) Anaplastic astrocytoma: prognostic factors and survival in 4807 patients with emphasis on receipt and impact of adjuvant therapy. J Neurooncol, 129(3): 557-65. [DOI:10.1007/s11060-016-2210-1] [PMID]
14. Tian M, Ma W, Chen Y, Yu Y, Zhu D, Shi J, et al. (2018) Impact of gender on the survival of patients with glioblastoma. Biosci Rep, 38(6). [DOI:10.1042/BSR20180752] []
15. Toledo M, Sarria-Estrada S, Quintana M, Maldonado X, Martinez-Ricarte F, Rodon J, et al. (2017) Epileptic features and survival in glioblastomas presenting with seizures. Epilepsy Res, 130: 1-6. [DOI:10.1016/j.eplepsyres.2016.12.013] [PMID]
16. Dobran M, Nasi D, Chiriatti S, Gladi M, Somma LD, Iacoangeli M, et al. (2018) Prognostic Factors in Glioblastoma: Is There a Role for Epilepsy? Neurol Med Chir (Tokyo) 58(3): 110-15. [DOI:10.2176/nmc.oa.2017-0167] []
17. Noiphithak R and Veerasarn K (2017) Clinical predictors for survival and treatment outcome of high-grade glioma in Prasat Neurological Institute. Asian J Neurosurg, 12(1): 28-33. [DOI:10.4103/1793-5482.148791] [PMID] []
18. Ahmadloo N, Kani AA, Mohammadianpanah M, Nasrolahi H, Omidvari S, Mosalaei A, et al. (2013) Treatment outcome and prognostic factors of adult glioblastoma multiforme. J Egypt Natl Canc Inst, 25(1): 21-30. [DOI:10.1016/j.jnci.2012.11.001] [PMID]
19. Fekete B, Werlenius K, Orndal C, Rydenhag B (2016) Prognostic factors for glioblastoma patients--a clinical population-based study. Acta Neurol Scand, 133(6): 434-41. [DOI:10.1111/ane.12481] [PMID]
20. Pessina F, Navarria P, Cozzi L, Ascolese AM, Simonelli M, Santoro A, et al. (2017) Maximize surgical resection beyond contrast-enhancing boundaries in newly diagnosed glioblastoma multiforme: is it useful and safe? A single institution retrospective experience. J Neurooncol, 135(1): 129-39. [DOI:10.1007/s11060-017-2559-9] [PMID]
21. Serventi J and Behr J (2018) Surgery and evidence-based treatments in patients with newly diagnosed high-grade glioma. Semin Oncol Nurs, 34(5): 443-53. [DOI:10.1016/j.soncn.2018.10.009] [PMID]
22. Illic R, Somma T, Savic D, Frio F, Milicevic M, Solari D, et al. (2017) A survival analysis with identification of prognostic factors in a series of 110 patients with newly diagnosed glioblastoma before and after introduction of the stupp regimen: A Single-Center Observational Study. World Neurosurg, 104: 581-88. [DOI:10.1016/j.wneu.2017.05.018]
23. Mineo JF, Bordron A, Baroncini M, Ramirez C, Maurage CA, Blond S, et al. (2007) Prognosis factors of survival time in patients with glioblastoma multiforme: a multivariate analysis of 340 patients. Acta Neurochir, 149(3): 245-53. [DOI:10.1007/s00701-006-1092-y]
24. Ma X, Lv Y, Liu J, Wang D, Huang Q, Wang X, et al. (2009) Survival analysis of 205 patients with glioblastoma multiforme: clinical characteristics, treatment and prognosis in China. J Clin Neurosci, 16(12): 1595-98. [DOI:10.1016/j.jocn.2009.02.036]
25. Lorentini S, Amelio D, Giri MG, Fellin F, Meliado G, Rizzotti A, et al. (2013) IMRT or 3D-CRT in glioblastoma? A dosimetric criterion for patient selection. Technol Cancer Res Treat, 12(5): 411-20. [DOI:10.7785/tcrt.2012.500341] [PMID]
26. Castellano A, Bailo M, Cicone F, Carideo L, Quartuccio N, Mortini P, et al. (2021) Advanced imaging techniques for radiotherapy planning of gliomas. Cancers (Basel), 13(5). [DOI:10.3390/cancers13051063] [PMID] []
27. Laprie A, Ken S, Filleron T, Lubrano V, Vieillevigne L, Tensaouti F, et al. (2019) Dose-painting multicenter phase III trial in newly diagnosed glioblastoma: the SPECTRO-GLIO trial comparing arm A standard radiochemotherapy to arm B radiochemotherapy with simultaneous integrated boost guided by MR spectroscopic imaging. BMC Cancer, 19(1): 167. [DOI:10.1186/s12885-019-5317-x] [PMID] []
28. Huang B, Yu Z, Liang R (2021) Effect of long-term adjuvant temozolomide chemotherapy on primary glioblastoma patient survival. BMC Neurol, 21(1): 424. https://doi.org/10.21203/rs.3.rs-505016/v1 https://doi.org/10.21203/rs.3.rs-785690/v1 [DOI:10.1186/s12883-021-02461-9]
29. Liu S, Zhao Q, Shi W, Zheng Z, Liu Z, Meng L, et al. (2021) Advances in radiotherapy and comprehensive treatment of high-grade glioma: immunotherapy and tumor-treating fields. J Cancer, 12(4): 1094-104. [DOI:10.7150/jca.51107] [PMID] []
30. Blumenthal DT, Gorlia T, Gilbert MR, Kim MM, Burt Nabors L, Mason WP, et al. (2017) Is more better? The impact of extended adjuvant temozolomide in newly diagnosed glioblastoma: a secondary analysis of EORTC and NRG Oncology/RTOG. Neuro Oncol, 19(8): 1119-26. [DOI:10.1093/neuonc/nox025] [PMID] []
31. Marta Domenech CF-F, et al. (2021) Long-term results of the GEINO 1401 TRIAL: Randomizing patients to stop or to continue temozolomide until 12 cycles. Journal of Clinical Oncology, 39(15): 2013-13. [DOI:10.1200/JCO.2021.39.15_suppl.2013]
32. Jiang T, Mao Y, Ma W, Mao Q, You Y, Yang X, et al. (2016) CGCG clinical practice guidelines for the management of adult diffuse gliomas. Cancer Lett, 375(2): 263-73. [DOI:10.1016/j.canlet.2016.01.024] [PMID]
33. Sonoda Y. (2020) Clinical impact of revisions to the WHO classification of diffuse gliomas and associated future problems. Int J Clin Oncol, 25(6): 1004-09. [DOI:10.1007/s10147-020-01628-7]
34. Arita H, Matsushita Y, Machida R, Yamasaki K, Hata N, Ohno M, et al. (2020) TERT promoter mutation confers favorable prognosis regardless of 1p/19q status in adult diffuse gliomas with IDH1/2 mutations. Acta Neuropathol Commun, 8(1): 201. [DOI:10.1186/s40478-020-01078-2] []
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Zhu H, Luo J. Postoperative intensity-modulated radiotherapy and chemotherapy in patients with high-grade glioma: analysis of efficacy and prognostic factors. Int J Radiat Res 2023; 21 (1) :139-145
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Volume 21, Issue 1 (1-2023) Back to browse issues page
International Journal of Radiation Research
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