title: Radiation therapy with or without surgery in the management of low-grade brain astrocytomas. A retrospective study of 120 patients.
abstract: From 1977 to 1988, 120 consecutive patients with a diagnosis of low-grade astrocytoma were referred to our department for radiotherapy. Fourty-one patients (group 1) underwent surgery and post operative external radiation therapy (2 gross total resections and 39 subtotal resections). Sixty-nine patients underwent exclusive external radiotherapy (group 2). In ten patients, the irradiation was delivered by stereotactic implantation of iridium-192 wires into the tumor with or without external irradiation (group 3). Ten had pilocytic astrocytomas (mean age, 24 years) and twenty had microcystic astrocytomas (mean age, 35.4 years). The 5- and 10-year survival rates were 55.6% and 44.4%, respectively and 55% and 48%. Ninety astrocytomas were classified as "ordinary" astrocytoma (mean age, 36.8 years). The 5- and 10-year overall survival rates were 51% and 20.5%, respectively. The same probabilities at 5 and 10 years were 65% and 37% respectively, for group 1, 38.8% and 12.7% for group 2 and, 78.8 and 22.5% for group 3. In multivariate analysis, two prognostic factors had a significant impact on overall survival: IK score (IK < 90 vs IK > or = 90, p = 0.0001), surgical resection (surgical resection and post operative radiotherapy vs radiation therapy alone, p = 0.012). However, the patients who underwent surgical resection were those in the best condition, having tumors that were easily accessible and less invasive.
authors.affiliation: Services de cancérologie-radiothérapie A et B, hôpital Tenon, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Touboul
authors.forename: M
authors.initials: M
authors.lastname: Schlienger
authors.forename: L
authors.initials: L
authors.lastname: Buffat
authors.forename: J
authors.initials: J
authors.lastname: Balosso
authors.forename: J F
authors.initials: JF
authors.lastname: Minne
authors.forename: L H
authors.initials: LH
authors.lastname: Schwartz
authors.forename: F
authors.initials: F
authors.lastname: Pene
authors.forename: T
authors.initials: T
authors.lastname: Masri-Zada
authors.forename: G
authors.initials: G
authors.lastname: Lot
authors.forename: B
authors.initials: B
authors.lastname: Devaux
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011182:Postoperative Care; D011183:Postoperative Complications; D011379:Prognosis; D011829:Radiation Dosage; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery