Radiotherapeutic management of high grade glial tumors and prognostic factors: Metropolitan Hospital experience

Abstract

OBJECTIVES Patients diagnosed with high grade glial tumors and treated in Metropolitan Hospital, were analysed retrospectively to evaluate radiotherapy results and the prognostic factors. METHODS One hundred and thirty-eight patients (63 females, 75 males) diagnosed with high grade glial tumors were analysed retrospectively to evaluate radiotherapy results and the prognostic factors. Radiotherapy was given after complete resection on 51 patients and after partial resection on 47 patients. The remaining 40 patients were irradiated after biopsy. Fifty-five patients received concomittant and/or adjuvant chemotherapy. RESULTS Median overall survival and progression free survival were 13 and 6 months. One and 2-year survival rates were %55 and %24 respectively. Univariate analysis showed that age (p=0.0021, p=0.0021), histology (p=0.0079, p=0.00001), resection type (p=0.04, p=0.01), Karnofsky Performance Status (KPS) (p=0.00001, p=0.00001) and Recursive Partitioning Analysis (RPA) (p=0.00001, p=0.000001) classification were the significant prognostic factors for the progression-free and overall survival. In multivariate analysis, KPS (p=0.03322), and RPA (p=0.0033) classification were the independent significant prognostic factors for overall and progression free survival respectively. CONCLUSION In our series KPS and RPA classification were the most significant prognostic factors for the progression and survival.

Keywords

• Prognosis,Glioma,Retrospective Studies,Survival,Astrocytoma,Radiotherapy

Yüksek gradlı glial tümörlerde radyoterapi sonuçları ve prognostik faktörler: Metropolitan Hastanesi deneyimi

Öz

AMAÇ Yüksek gradlı glial tümörlerde radyoterapi sonuçlarını ve prognostik faktörleri değerlendirmek amacıyla Metropolitan Hastanesi'nde tedavi edilen olgular geriye dönük olarak analiz edildi. GEREÇ VE YÖNTEM Eylül 1998 ile Ocak 2007 tarihleri arasında yüksek gradlı gliom tanısıyla tedavi edilen toplam 138 olgu (63 kadın, 75 erkek) geriye dönük olarak incelendi. Olguların 51'ine total rezeksiyon, 47'sine subtotal rezeksiyon, 40'ına biyopsi sonrası radyoterapi uygulandı, 55 olguya eşzamanlı ve/veya adjuvan kemoterapi verildi. BULGULAR Genel sağkalım medyan 13 ay, progresyonsuz sağkalım medyan 6 ay, 1 ve 2 yıllık sağkalım oranları %55 ve %24'tür. Progresyon ve sağkalıma etkili faktörler tek değişkenli analizde sırasıyla yaş (p=0,0021, p=0,0021), histoloji (p=0,0079, p=0,00001), rezeksiyon genişliği (p=0,04, p=0,01), Karnofsky Performans Skoru (KPS) (p=0,00001, p=0,00001) ve “Recursive Partitioning Analysis” (RPA) sınıfıdır (p=0,00001, p=0,000001). Çok değişkenli analizde genel sağkalım için KPS (p=0,03322), progresyonsuz sağkalım için RPA sınıfı (p=0,0033) anlamlı prognostik faktörlerdir. SONUÇ Serimizde KPS ve RPA sınıflandırması progresyon ve sağkalıma etki eden en önemli prognostik faktörler olarak bulunmuştur.

Anahtar Kelimeler

• Prognostik faktörler, radyoterapi, sağkalım, yüksek gradlı glial tümör.

Kaynakça

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