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J Korean Soc Ther Radiol > Volume 11(2); 1993 > Article
Journal of the Korean Society for Therapeutic Radiology 1993;11(2): 249-258.
The Role of Radiation Therapy in the Treatment of Intracranial Glioma: Retrospective Analysis of 96 Cases
Yeon Sil Kim, Ki Mun Kang, Byung Ock Choi, Sei Chul Yoon, Kyung Sub Shin, Jun Gi Kang
1Department of Therapeutic Radiology, Catholic University Medical College, Kangnam St. Mary's Hpsital, Seoul, Korea.
2Department of Neurosurgery, Kangnam St. Mary's Hpsital, Seoul, Korea.
Between March 1983 and December 1989, ninety-six patients with intracranial glioma were treated in the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. We retrospectively reviewed each case to evaluate variable factors influencing the treatment results and to develop an optimal therapy Policy. Median follow-up is 57 months(range:31~133 months). Of the 96 patients, 60(63%) were males and 36(37%) were females. Ages ranged from 3 to 69 years (median 42 years). The most common presenting symtoms were headache(67%) followed by cerebral motor and sensory discrepancy(54%), nausea and vomiting(34%), seizure (19%), mental change(10%) and memory and calculation impairment(8%). Eighty five(88.5%) patients all, except 11(11.5%) brain stem lesions, were biopsy proven intracranial glioma. The distribution by histologic type was 64 astrocytomas(75%), 4 mixed oligoastrocytomas(5%), and 17 oligodendrogliomas(20%). Fourty nine patients (58%) were grade I,II histology and 36 (42%) patients were grade III, IV histology. Of the 96 patients, 64(67%) recieved postoperative RT and 32(33%) were treated with primary radiotherapy. Gross total resection was performed in 14(16%) patients, subtotal resection in 29(34%), partial resection in 21(25%), and biopsy only in 21(25%). Median survival time was 53 months(range 2~133 months), and 2- and, 5-year survival rate were 69%, 49% respectively. 5-year survival rate by histologic grade was gradeI, 70%, gradeII, 58%, grade III, 28%, and grade IV, 15%. Multivariated analysis demonstrate that age at diagnosis (p=0.121), Karnofsky performance Status(KPS)(p=0.0002), histologic grade(p=0.0001), postoperative radiation therapy(p=0.0278), surgical extent(p=0.024), cerebellar location of tumor(p=0.0095) were significant prognostic factors influencing on survival.
Key Words: Intracranial glioma, Radiation therapy, Prognostic factors
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