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Adult patients with supratentorial pilocytic
astrocytomas: a prospective multicenter clinical trial
Brown PD, Buckner JC, O'Fallon JR, Iturria NL, Brown CA, O'Neill BP,
Scheithauer BW, Dinapoli RP, Arusell RM, Abrams RA, Curran WJ, Shaw EG, North
Central Cancer Treatment Group, Mayo Clinic
Department of Oncology, Mayo Clinic, Rochester, MN 55905, USA.
brown.paul@mayo.edu
Purpose. Supratentorial pilocytic astrocytomas in adults are
uncommon.
A prospective clinical trial was conducted to obtain clinical and outcome data
in these patients.
Methods and Materials. Between 1986 and 1994, 20 eligible adults with
supratentorial pilocytic astrocytomas were enrolled in a prospective intergroup
trial of radiotherapy (RT) after biopsy (3 patients) or observation after gross
(11 patients) or subtotal (6 patients) resection.
Results. At the time of analysis (median follow-up, 10 years), 1
patient (5%) had died and 19 patients (95%) were alive.
The 5-year progression-free and overall survival rates were 95%.
The cause of death in the patient who died (2.1 years after enrollment) was
unknown; a radiographic examination obtained shortly before the patient's demise
revealed no signs of progression.
Progression in 1 patient approximately 1 month after enrollment required
injection of (32)P into an enlarging cyst.
The patient required RT approximately 18 months later because of further
progression.
This patient was alive without evidence of progression 9 years after RT.
No toxic effects had been recorded at the latest follow-up examinations.
Conclusion. With follow-up comparable or superior to that in many
retrospective studies, the results of this prospective trial confirm that adults
with pilocytic astrocytomas have a favorable prognosis with regard to survival
and neurologic function.
The vast majority of patients remained stable after gross or subtotal resection
and no adjuvant therapy.
RT need not be offered to adults with supratentorial pilocytic astrocytoma after
gross or subtotal resection; instead, close observation is recommended.
Because only 3 patients received RT after biopsy, it is difficult to comment on
the effect of RT on their outcome as a group.
PMID: 15001258 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15001258
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