Postoperative radiation therapy for low‐grade glioma

Abstract

BACKGROUND: The role of postoperative radiotherapy (PORT) in the management of low‐grade glioma remains controversial. An analysis using data from the European Organization for Research and Treatment of Cancer 22844/22845 studies concluded that several factors portend a poor prognosis: age ≥40 years, astrocytoma histology, tumor size ≥6 cm, tumor crossing midline, and preoperative neurologic deficits. PORT may benefit patients with high‐risk features. The aim of this study was to assess temporal trends and determinants of the use of PORT. METHODS: By using data from the Surveillance, Epidemiology, and End Results program, the authors identified 1127 adult patients diagnosed with low‐grade glioma (World Health Organization grade I and II) who underwent surgical resection between January 1, 1998 and December 31, 2006. The primary outcome was receipt of PORT. The authors performed multivariate logistic regression to examine the association between clinical, patient, and demographic characteristics and receipt of PORT. RESULTS: Receipt of PORT declined during the study period, from 64% of patients in 1998 to 36% of patients in 2006. On multivariate analysis, significant predictors of receipt of PORT were age ≥40 years, tumor crossing midline, and partial surgical resection. CONCLUSIONS: The use of PORT for patients with low‐grade glioma has declined in the period from 1998 to 2006 for both low‐risk and high‐risk patients. Cancer 2012. © 2011 American Cancer Society.

Multi-institutional study of treatment patterns in Korean patients with WHO grade II gliomas: KNOG 15-02 and KROG 16-04 intergroup study

“…We examined the association between patient/tumor characteristics and adjuvant treatment. Well-known predictors of adjuvant RT are age ≥ 40 years, tumor crossing midline, and partial surgical resection [11]. The extent of resection significantly affected the decision on adjuvant treatment in our study.…”

Management of supratentorial recurrent low-grade glioma: A multidisciplinary experience in 35 adult patients

“…The definition of low- vs. high-risk patients, including the cut-off age of 40 years, varies across studies ( 4 , 9 ). To the best of our knowledge, there is no evidence demonstrating that immediate (post-operative) EBRT is advantageous in improving the OS time of patients with LGGs compared with deferred radiotherapy ( 21 , 22 ). The PFS of patients with LGGs is lengthened; however, the optimal timing for receiving EBRT remains debatable ( 21 , 22 ).…”

“…To the best of our knowledge, there is no evidence demonstrating that immediate (post-operative) EBRT is advantageous in improving the OS time of patients with LGGs compared with deferred radiotherapy ( 21 , 22 ). The PFS of patients with LGGs is lengthened; however, the optimal timing for receiving EBRT remains debatable ( 21 , 22 ). Based on 19 years of experience, Youland et al ( 23 ) suggested that immediate postoperative EBRT should be implemented only for high-risk patients.…”