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Int. J. Radiat. Oncol. Biol. Phys. · Mar 2006
Multicenter StudySpinal cord gliomas: A multi-institutional retrospective analysis.
- May Abdel-Wahab, Blessing Etuk, James Palermo, Hiroki Shirato, John Kresl, Ozlem Yapicier, Gail Walker, Bernd W Scheithauer, Edward Shaw, Charles Lee, Walter Curran, Terry Thomas, and Arnold Markoe.
- Department of Radiation Oncology, University of Miami, Miami, FL, USA. mwahab@med.miami.edu
- Int. J. Radiat. Oncol. Biol. Phys. 2006 Mar 15; 64 (4): 1060-71.
PurposeTo determine the impact of postoperative radiation therapy (POXRT) on outcome in spinal cord gliomas.Patients And MethodsData from 242 patients were collected retrospectively from six institutions using a standardized data sheet. Pathology specimens, when available, were centrally reviewed.ResultsA total of 183 patients were analyzed: 82 received surgery alone as initial treatment, whereas 101 had surgery and POXRT. Demographic, diagnostic, and treatment factors were analyzed for impact on progression-free (PFS) and overall survival (OS). PFS in ependymoma patients was 74%, 60%, and 35% at 5, 10, 15 years, respectively, and was significantly influenced by treatment type, race, age, tumor grade, and type of surgery on univariate analysis, with age being the only significant factor on multivariate analysis (MVA) (p = 0.01). OS of ependymoma patients was 91%, 84%, and 75% at 5, 10, and 15 years, respectively, and was significantly influenced by both complete resection (p = 0.04) and age (p = 0.03) on MVA. In astrocytomas, PFS was 42%, 29%, and 15% at 5, 10, and 15 years, and was significantly influenced by POXRT in low- and intermediate-grade tumors on MVA (p = 0.02). OS at 5, 10, and 15 years was 59%, 53%, and 32%, respectively, and was significantly influenced by grade on MVA (p < 0.01).ConclusionPostoperative radiation therapy reduced disease progression in low- and moderate-grade astrocytomas. In ependymomas, complete resection significantly influenced OS.
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