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Early toxicity predicts long-term survival in high-grade glioma.
Department of Radiation Oncology Faculty Papers
  • Y. R. Lawrence, Thomas Jefferson University
  • M Wang, Radiation Therapy Oncology Group, 1818 Market Street, Suite 1600, Philadelphia, PA 19103-3604, USA
  • Adam Dicker, Thomas Jefferson University
  • David W Andrews, Thomas Jefferson University
  • Walter J Curran, Thomas Jefferson University
  • J M Michalski, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8224, St Louis, MO
  • L Souhami, McGill University, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada
  • W-Ka Yung, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Boulevard., Houston, TX
  • M Mehta, Northwestern University Feinberg School of Medicine, 251 East Huron Street, Chicago, IL
Document Type
Article
Publication Date
4-26-2011
Disciplines
Comments

This article has been peer reviewed. It was published in: British Journal of Cancer.

Volume 104, Issue 9, April 2011, Pages 1365-71.

The published version is available at DOI: 10.1038/bjc.2011.123. Copyright © Nature

Abstract

BACKGROUND: Patients with high-grade gliomas are treated with surgery followed by chemoradiation. The risk factors and implications of neurological side effects are not known.

METHODS: Acute and late ≥ grade 3 neurological toxicities (NTs) were analysed among 2761 patients from 14 RTOG trials accrued from 1983 to 2003. The association between acute and late toxicity was analysed using a stepwise logistic regression model. The association between the occurrence of acute NT and survival was analysed as an independent variable.

RESULTS: There were 2610 analysable patients (86% glioblastoma, 10% anaplastic astrocytoma). All received a systemic agent during radiation (83% chemotherapy, 17% biological agents). Median radiation dose was 60 Gy. There were 182 acute and 83 late NT events. On univariate analysis, older age, poor performance status, aggressive surgery, pre-existing neurological dysfunction, poor mental status and twice-daily radiation were associated with increased acute NT. In a stepwise logistic regression model the occurrence of acute NT was significantly associated with late NT (OR=2.40; 95% CI=1.2-4.8; P=0.014). The occurrence of acute NT predicted poorer overall survival, independent of recursive partitioning analysis class (median 7.8 vs 11.8 months).

INTERPRETATION: Acute NT is significantly associated with both late NT and overall survival.

Citation Information
Y. R. Lawrence, M Wang, Adam Dicker, David W Andrews, et al.. "Early toxicity predicts long-term survival in high-grade glioma." (2011)
Available at: http://works.bepress.com/yaacov_lawrence/2/