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Radiation
response and survival time in patients with glioblastoma multiforme
Barker
FG 2nd, Prados MD, Chang SM, Gutin PH, Lamborn KR, Larson DA, Malec MK,
McDermott MW, Sneed PK, Wara WM, Wilson CB
Neuro-Oncology
Service of the Brain Tumor Research Center, Department of Neurological Surgery,
School of Medicine, University of California, San Francisco, USA
The
determine the value of radiographically assessed response to radiation therapy
as a predictor of survival in patients with glioblastoma multiforme (GBM), the
authors studied a cohort of 301 patients who were initially treated according to
uniform clinical protocols.
All patients had newly diagnosed supratentorial GBM and underwent the maximum
safe resection followed by external- beam radiation treatment (60 Gy in standard
daily fractions or 70.4 Gy in twice-daily fractions of 160 cGy).
The radiation response and survival rates were assessable in 222 patients.
The extent of resection and the immediate response to radiation therapy were
highly correlated with survival, both in a univariate analysis and after
correction for age and Karnofsky performance scale (KPS) score in a multivariate
Cox model (p< 0.001 for radiation response and p=0.04 for extent of
resection).
A subgroup analysis suggested that neuroimaging obtained within 3 days after
surgery served as a better baseline for assessment of radiation response than
images obtained later.
Imaging obtained within 3 days after completion of a course of radiation therapy
also provided valid radiation response scores.
The impact of the radiographically assessed radiation response on survival time
was comparable to that of age or KPS score. This information is easily obtained
early in the course of the disease, may be of value for individual patients, and
may also have implications for the design and analysis of trials of adjuvant
therapy for GBM, including volume-dependent therapies such as radiosurgery or
brachytherapy.
PMID:
8609556 [PubMed - indexed for MEDLINE]
Source:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8609556&dopt=Abstract
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