期刊
BRITISH JOURNAL OF CANCER
卷 104, 期 9, 页码 1365-1371出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/bjc.2011.123
关键词
glioblastoma; toxicity; normal tissue effects; radiation therapy
类别
资金
- National Cancer Institute [U10 CA21661, U10 CA37422, U24 CA81647]
- ASCO Cancer Foundation
- National Institutes of Health [CA10663]
- Tobacco Research Settlement Fund (State of Pennsylvania)
- Christine Baxter Fund
BACKGROUND: Patients with high-grade gliomas are treated with surgery followed by chemoradiation. The risk factors and implications of neurological side effects are not known. METHODS: Acute and late >= grade 3 neurological toxicities (NTs) were analysed among 2761 patients from 14 RTOG trials accrued from 1983 to 2003. The association between acute and late toxicity was analysed using a stepwise logistic regression model. The association between the occurrence of acute NT and survival was analysed as an independent variable. RESULTS: There were 2610 analysable patients (86% glioblastoma, 10% anaplastic astrocytoma). All received a systemic agent during radiation (83% chemotherapy, 17% biological agents). Median radiation dose was 60 Gy. There were 182 acute and 83 late NT events. On univariate analysis, older age, poor performance status, aggressive surgery, pre-existing neurological dysfunction, poor mental status and twice-daily radiation were associated with increased acute NT. In a stepwise logistic regression model the occurrence of acute NT was significantly associated with late NT (OR = 2.40; 95% CI = 1.2-4.8; P = 0.014). The occurrence of acute NT predicted poorer overall survival, independent of recursive partitioning analysis class (median 7.8 vs 11.8 months). INTERPRETATION: Acute NT is significantly associated with both late NT and overall survival. British Journal of Cancer (2011) 104, 1365-1371. doi:10.1038/bjc.2011.123 www.bjcancer.com Published online 12 April 2011 (C) 2011 Cancer Research UK
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