Long-term follow-up in managing anaplastic astrocytoma by multimodality approach with surgery followed by postoperative radiotherapy and PCV-chemotherapy: Phase II trial

Ilan G. Ron, Ofer Gal, Tal H. Vishne, Felix Kovner

Research output: Contribution to journalArticlepeer-review

Abstract

Overall survival and progression-free survival after 5 and 10 years of 31 patients with malignant glioma treated by a combination of surgery, postoperative radiotherapy, and chemotherapy with a PCV regimen (procarbazine, CCNU [lomustine] and vincristine) is described. Parameters were evaluated by age at diagnosis, gender, ethnic origin, pre- and postsurgery Karnofsky Performance Status (KPS) score, limit and amount of surgical resection, histopathologic type, number of chemotherapy courses, time between surgery and radiotherapy, response to combined therapy, and dosage and type of radiotherapy. Progression-free survival was 29% at 24 months and 22% at 60 and 120 months. Overall survival was 47%, 36%, and 36% after 24, 60, and 120 months, respectively. Favorable prognostic factors for survival in univariate analysis were preand postoperative KPS (≥70; p = 0.015; p = 0.0025, respectively), age of patients (<40; p = 0.01), number of chemotherapy cycles (≥6; p = 0.02), and radiation dose (≥60 Gy; p = 0.0015). The only significant prognostic factors for overall survival in a stepwise multivariate analysis were irradiation dose (p = 0.0001), number of chemotherapy cycles (p = 0.001), and preoperative KPS (p = 0.05); for progression-free survival it was number of chemotherapy cycles (p = 0.004). Survival was not affected by excision size, radiation method, histopathologic type of tumor, gender, ethnic origin, or time lapsed between surgery and irradiation.

Original languageEnglish
Pages (from-to)296-302
Number of pages7
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume25
Issue number3
DOIs
StatePublished - 2002
Externally publishedYes

Keywords

  • Anaplastic astrocytoma
  • Malignant glioma
  • PCV chemotherapy (procarbazine, CCNU [lomustine], vincristine)
  • Performance status
  • Postoperative radiotherapy

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