A randomized trial on dose-response in radiation therapy of low-grade cerebral glioma: European Organization for Research and Treatment of Cancer (EORTC) study 22844
A.B.M.F. Karim,B. Maat,R. Hatlevoll,Johan Menten,Ewald H. J. M. Rutten,D.G.T. Thomas,F. Mascarenhas,Jean-Claude Horiot,L.M. Parvinen,M. van Reijn,Jos J. Jager,M.G. Fabrini,A.M. van Alphen,H.P. Hamers,L. Gaspar,E. Noordman,Marianne Pierart,M. van Glabbeke +17 more
TLDR
The EORTC trial 22844 has not revealed the presence of radiotherapeutic dose-response for patients with LGG for the two dose levels investigated with this conventional setup, but objective prognostic parameters are recognized.Abstract:
Purpose : Cerebral low-grade gliomas (LGG) in adults are mostly compose of astrocytomas, oligodendrogliomas, and mixed oligoastrocytomas. There is at present no consensus in the policy of treatment of these tumors. We sought to determine the efficacy of radiotherapy and the presence of a dose-response relationship for these tumors in two multicentric randomized trials conducted by the European Organization for Research and Treatment of Cancer (EORTC). The dose-response study is the subject of this article. Methods and Materials : For the dose-response trial, 379 adult patients with cerebral LGGs were randomized centrally at the EORTC Data Center to receive irradiation postoperatively (or postbiopsy) with either 45 Gy in 5 weeks or 59.4 Gy in 6.6 weeks with quality-controlled radiation therapy. All known parameters with possible influences on prognosis were prospectively recorded. Conventional treatment techniques were recommended. Results : With 343 (91%) eligible and evaluable patients followed up for at least 50 months with a median of 74 months, there is no significant difference in terms of survival (58% for the low-dose arm and 59% for the high-dose arm) or the progression free survival (47% and 50%) between the two arms of the trial. However, this prospective trial has revealed some important facets about the prognostic parameters: The T of the TNM classifications as proposed in the protocol appears to be one of the most important prognostic factors (p Conclusion : The EORTC trial 22844 has not revealed the presence of radiotherapeutic dose-response for patients with LGG for the two dose levels investigated with this conventional setup, but objective prognostic parameters are recognized. The tumor size or T parameter as used in this study appears to be a very important factor.read more
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Clinical practice guidelines in oncology
William J. Gradishar,Benjamin O. Anderson,Ron Balassanian,Sarah L. Blair,Harold J. Burstein,Amy E. Cyr,Anthony D. Elias,William B. Farrar,Andres Forero,Sharon H. Giordano,Matthew P. Goetz,Lori J. Goldstein,Steven J. Isakoff,Janice A. Lyons,P. Kelly Marcom,Ingrid A. Mayer,Beryl McCormick,Meena S. Moran,Ruth O'Regan,Sameer A. Patel,Lori J. Pierce,Elizabeth C. Reed,Kilian E. Salerno,Lee S. Schwartzberg,Amy Sitapati,Karen L. Smith,Mary Lou Smith,Hatem Soliman,George Somlo,Melinda L. Telli,John H. Ward,Rashmi Kumar,Dorothy A. Shead +32 more
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Primary brain tumours in adults
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Role of Extent of Resection in the Long-Term Outcome of Low-Grade Hemispheric Gliomas
Justin S. Smith,Edward F. Chang,Kathleen R. Lamborn,Susan M. Chang,Michael D. Prados,Soonmee Cha,Tarik Tihan,Scott R. VandenBerg,Michael W. McDermott,Mitchel S. Berger +9 more
TL;DR: Improved outcome among adult patients with hemispheric LGG is predicted by greater EOR, and progression-free survival was predicted by log preoperative tumor volume and postoperative volume.
Journal ArticleDOI
Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial.
M. J. van den Bent,D Afra,O De Witte,M Ben Hassel,S. Schraub,Khê Hoang-Xuan,Per-Uno Malmström,Laurence Collette,Marianne Pierart,René-Olivier Mirimanoff,Abmf Karim +10 more
TL;DR: Early radiotherapy after surgery lengthens the period without progression but does not affect overall survival, and Radiotherapy could be deferred for patients with low-grade glioma who are in a good condition, provided they are carefully monitored.
Journal ArticleDOI
Prognostic Factors for Survival in Adult Patients With Cerebral Low-Grade Glioma
Francesco Pignatti,Martin J. van den Bent,Desmond Curran,C. Debruyne,Richard Sylvester,Patrick Therasse,D Afra,Philippe Cornu,Michel Bolla,Charles J. Vecht,A.B.M.F. Karim +10 more
TL;DR: In adult patients with LGG, older age, astrocytoma histology, presence of neurologic deficits before surgery, largest tumor diameter, and tumor crossing the midline were important prognostic factors for survival and can be used to identify low-risk and high-risk patients.
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