Actr-56. Upfront Chemoradiotherapy in Grade 2 Low Grade Glioma, a Single Institution Experience
Year: 2016
Type: conference-abstract
Abstract: A recent randomized phase III study demonstrated survival improvement with chemoradiotherapy (CRT) over radiotherapy (RT) alone for WHO Grade II gliomas (LGG). PCV chemotherapy, utilized in this trial, is not commonly used in the US. We analyze our retrospective dataset of predominantly temozolomide-based CRT. Retrospective review of 111 LGG patients (years 2000–2013) in a single institution pathology database was performed. We identified 51 patients with LGG that were treated with upfront RT. Characteristics including age, gender, high-risk features (age≥40, tumor size>6 cm, tumor crossing midline, neurologic deficit at diagnosis), and use of RT and chemotherapy were determined. 16 patients received CRT (14 of which received temozolomide), and 35 patients received RT alone (median dose 54Gy). 46 patients had high risk LGG (15/16 receiving CRT, 31/35 receiving RT alone). Survival and progression free survival, based on serial imaging and electronic medical records, were assessed. Kaplan Meier analysis was used to assess time to events, and log rank test was used to compare patients who received RT to those receiving CRT. 5-year progression free survival for patients receiving CRT was 72% versus 54% in patients receiving radiation alone (p=0.03). 5-year overall survival for patients receiving CRT was 93% versus 79% in patients receiving radiation alone (p=0.04). Cox Proportional Hazards analysis revealed that patients with biopsy alone (HR=7.24, p=0.03), RT alone (HR=4.08, p=0.04) and having neurologic deficit at presentation (HR=4.57, p<0.01) had increased risk of death. Cox Proportional Hazards analysis showed that use of upfront RT was the only factor that increased the risk of earlier recurrence (HR=2.72, p=0.03). Use of upfront predominantly temozolomide-based CRT had overall survival benefit over RT alone in a population of WHO grade II gliomas treated. CRT was the only factor in this study that predicted for improved time to recurrence.
Source: Neuro-Oncology
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2587047377