|
On
the issue of early and aggressive treatment in grade 2 gliomas
Ribom
D, Smits A, Hartman M, Persson L, Blomquist E
Department
of Neuroscience, University Hospital, 751 85 Uppsala, Sweden.
dan.ribom@neurologi.uu.se
Purpose.
To study the effects of surgery and timing of radiotherapy on patient
survival in grade 2 gliomas.
Methods.
One hundred and eighty-nine patients with diffuse astrocytomas,
oligoastrocytomas, and oligodendrogliomas, World Health Organization
grade 2, treated between 1982 and 2000 were identified.
The
impact of treatment given and clinical parameters were studied in
univariate- and multivariate survival analyses.
Results.
Median survival for the whole patient sample was 6.4 years and the
5-year survival rate was 60%.
Macroscopic
total resection was beneficial in the univariate analysis (P=0.03) but
not when adjusting for confounders.
Early
subtotal resection did not prolong survival.
Early
radiotherapy was associated with a shorter survival time compared to
delayed or no irradiation (P=0.004).
However,
this difference was mainly due to an unequal distribution of
prognostic factors and was not significant in the multivariate
analysis.
The
most important predictors for long survival time were young age (
P<0.001), oligodendroglioma histology ( P<0.001), and small
tumour size (P=0.02).
Conclusions.
Early conventional treatment with surgery and radiotherapy had no
positive effect on patient survival.
This
opens up the possibility of trying and evaluating other first-line
treatment regimens in this disease.
PMID: 12712330 [PubMed - indexed for MEDLINE]
|
