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KMID : 0859320090270010023
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Journal of the Korean Society for Therapeutic Radiology and Oncology
2009 Volume.27 No. 1 p.23 ~ p.28
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External Beam Radiotherapy in the Management of Low Grade Astrocytoma of the Brainㄷ
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Chun Ha-Chung
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Abstract
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Purpose: This study was designed to evaluate the effectiveness of postoperative radiotherapy for patients with
low-grade astrocytomas and to define an optimal radiotherapeutic regimen and prognostic factors.
Materials and Methods: A total of 69 patients with low-grade astrocytomas underwent surgery and postoperative
radiotherapy immediately following surgery at our institution between October 1989 and September 2006. The median patient age was 36 years. Forty-one patients were 40 years or younger and 28 patients were 41 years or older. Fourteen patients underwent a biopsy alone and the remaining 55 patients underwent a subtotal resection. Thirty-nine patients had a Karnofsky performance status of less than 80% and 30 patients had a Karnofsky performance status greater than 80%. Two patients were treated with whole brain irradiation followed by a coned down boost field to the localized area. The emaining 67 patients were treated with a localized field with an appropriate margin. Most of the patients received a dose of 50∼55 Gy and majority of the patients were treated with a dose of 54 Gy.
Results: The overall 5-year and 7-year survival rates for all of the 69 patients were 49% and 44%, respectively.
Corresponding disease free survival rates were 45% and 40%, respectively. Patients who underwent a subtotal resection showed better survival than patients who underwent a biopsy alone. The overall 5-year survival rates for patients who underwent a subtotal resection and patients who underwent a biopsy alone were 57% and 38%, respectively (p＜0.05). Forty-one patients who were 40 years or younger showed a better overall 5-year survival rate as compared with 28 patients who were 41 years or older (56% versus 40%, p＜0.05). The overall 5-year survival rates for 30 patients with a Karnofsky performance status greater than 80% and 39 patients with a Karnofsky performance status less than 80% were 51% and 47%, respectively. This finding was not statistically significant. Although one patient was not able to complete the treatment because of neurological deterioration, there were no significant treatment related toxicities.
Conclusions: Postoperative radiotherapy following surgery is a safe and effective treatment for patients with
low-grade astrocytomas. The extent of surgery and age were noted as significant prognostic factors in this study. However, further effective treatment might be necessary in the future to improve long-term survival rates.
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KEYWORD
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Radiotherapy, Low-grade astrocytoma
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