Post-operative efficacy of chemo-radiotherapy and prognosis analysis on 112 cases of high-grade gliomas
10.3781/j.issn.1000-7431.2009.07.014
- VernacularTitle:高分级神经胶质瘤112例术后放、化疗疗效及其预后分析
- Author:
Yang WANG
;
Xiaofang SHENG
;
Jing GAO
;
Shu CHEN
;
Wei DONG
;
Jiazhong DAI
;
Li PAN
- Publication Type:Journal Article
- Keywords:
Glioma;
Radiotherapy;
Radiotherapy,intensity-modulated;
Prognosis
- From:
Tumor
2009;(7):668-672
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the outcome and prognostic factors of conventional radiotherapy followed by intensity-modulated radiation therapy (IMRT) as a boost combined with chemotherapy in the treatment of high-grade gliomas (HGG). Methods:From Nov. 2004 to Nov. 2006, 112 HGG patients were treated with conventional radiotherapy followed by IMRT as a boost combined with chemotherapy. The radiotherapy regimen included first-course conventional radiotherapy and latE-course IMRT as a boost with the total radiation dosage of 57.5- 62.5Gy (27-29 fractions in 37-45 days). All the patients received chemotherapy. Sixty-three patients received temozolomidE-based chemotherapy and 49 patients received semustine plus teniposide chemotherapy. The treatment reaction was recorded. The overall survival rate and local progression-free survival rate were calculated. The prognostic factors were analyzed by using multivariate COX regression model. Results:The acute treatment toxicity was the most at grade 1 to grade 2 and no grade 4 adverse reaction was observed. Three cases had late radiation-induced brain necrosis. The overall 1-, 2-, and 3-year survival rates were 78.9%, 54.7%, and 30.8%, respectively. Multivariate analysis revealed that tumor location (P=0.001) and KPS score (P=0.011) were independent prognostic factors. The 1-, 2-, 3-year local progression-free survival rates were 63.8%, 38.9%, and 10.5%, respectively. Multivariate analysis revealed that tumor location (P=0.001), KPS score (P=0.001), and histologic type (P=0.005) were independent prognostic factors. Multivariate analysis did not reveal the significant correlation of temozolomide chemotherapy with the prognosis of the patients. Conclusion:Postoperative conventional radiotherapy followed by IMRT as a boost combined with chemotherapy has better short-term efficacy in the treatment of HGG and the adverse reaction is tolerable. KPS score, tumor location, and histologic type are important prognostic factors. Temozolomide chemotherapy is not associated with the prognosis of patients.
