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Survival
comparison of radiosurgery-eligible and -ineligible malignant glioma patients
treated with hyperfractionated radiation therapy and carmustine: a report of
Radiation Therapy Oncology Group 83-02
Curran WJ Jr, Scott CB, Weinstein AS, Martin LA, Nelson JS, Phillips TL,
Murray K, Fischbach AJ, Yakar D, Schwade JG, et al.
Fox Chase Cancer Center, Philadelphia, PA 19111
Purpose. The purpose is twofold:
(1) to identify the malignant glioma patients treated in a trial of
hyperfractionated radiotherapy (RT) and carmustine (BCNU) who may have been
eligible for a stereotactic radiosurgery (SRS) boost; and
(2) to compare survival of such patients with that of those considered
SRS-ineligible.
Patients
and Methods. From
January 1983 to July 1989, 778 malignant glioma patients were enrolled on
Radiation Therapy Oncology Group (RTOG) 83-02, a randomized phase I/II
hyperfractionated RT dose-escalation trial with BCNU chemotherapy.
The SRS criteria used in a single-institution trial were applied to these
patients; they are: Karnofsky performance status (KPS) of greater than 60;
well-circumscribed tumor less than 4.0 cm; no subependymal spread; and a
location not adjacent to brainstem or optic chiasm.
Results.
Eighty-nine patients (11.9%) were identified as potentially SRS-eligible.
The median survival times (MST) and 18-month survival rates of the 89 eligible
and 643 ineligible patients were 14.4 versus 11.7 months and 40% versus 27%,
respectively (P = .047).
The MST and 18-month survival rate of the 544 SRS-ineligible patients with KPS
greater than 60 were 12.1 months and 29%, respectively, and were not
statistically inferior to the survival of the SRS-eligible group (P =
.21).
Multivariate analysis revealed age, KPS, and histopathology to be strongly
predictive of survival, and SRS eligibility was also significantly predictive (P
= .047).
Conclusion.
SRS-eligible patients enrolled on RTOG 83-02 had survival superior to that of
the SRS-ineligible group, and this advantage is mainly due to the selection of a
subgroup with a high minimum KPS.
PMID:
8487050 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8487050&dopt=Abstract |
