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J Korean Soc Ther Radiol Oncol > Volume 28(3); 2010 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2010;28(3): 117-124. doi: https://doi.org/10.3857/jkstro.2010.28.3.117
Treatment Outcome and Analysis of the Prognostic Factors of High Grade Glioma Treated by Postoperative Radiotherapy
Sun Min Lee, Young Je Park, Won Sup Yoon, Suk Lee, Dae Sik Yang, Yong Gu Jeong, Chul Yong Kim
1Department of Radiation Oncology, Korea University College of Medicine, Seoul, Korea. kcyro@korea.ac.kr
2Department of Neurosurgery, Korea University College of Medicine, Seoul, Korea.
To analyze the postoperative radiotherapy results and prognostic factors in patients with WHO grade 3 and 4 gliomas.
A total of 99 patients with malignant gliomas who underwent postoperative radiotherapy between 1988 and 2007 were enrolled in this study. Total resections, subtotal resections (> or =50%), partial resections (<50%), and biopsies were performed in 16, 38, 22, and 23 patients, respectively. In total there were 32, 63 and 4 WHO grade 3, 4, and unspecified high grade gliomas, respectively. The biologically equivalent dose was in the range of 18.6 to 83.3 Gy(10) (median dose, 72.2 Gy(10)). We retrospectively analyzed survival rate, patterns of failure, prognostic factors, and adverse effects.
The median follow-up time was 11 months and there were 54 patients (54.5%) with local failure. The one and 2-year survival rates were 56.6% and 29.3%, respectively, and the median survival duration was 13 months. The one and 2-year progression-free survival rates (PFS) were 31.3% and 18.2%, respectively, and the median PFS was 7 months. The prognostic factors for overall survival were age (p=0.0001), surgical extents (subtotal resection, p=0.023; partial resection, p=0.009; biopsy only, p=0.002), and enhancement of tumor in postoperative imaging study (p=0.049). The factors affecting PFS were age (p=0.036), tumor enhancement of the postoperative imaging study (p=0.006). There were 3 patients with grade 3 and 4 side effects during and after radiotherapy.
In addition to age and surgical extents, tumor enhancement of the postoperative imaging study was included in the prognostic factors. The most common relapse patterns were local failures and hence, additional studies are needed to improve local control rates.
Key Words: High grade glioma, Prognostic factor, Radiation therapy
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