title: Treatment outcomes and prognostic factors in patients with supratentorial low-grade gliomas.
abstract: Low-grade gliomas account for 10-15% of all adult primary intracranial tumours. Currently, there is no consensus on the treatment strategy for low-grade gliomas. This study was designed to evaluate the treatment outcomes, prognostic factors and radiation-related late complications, as well as to assess whether or not post-operative radiotherapy has benefit on local control and overall survival in this population. We retrospectively reviewed 93 consecutive adult patients with supratentorial low-grade gliomas diagnosed at our institution from July 1985 to December 1997. All patients underwent surgical intervention and 60 of them received post-operative radiotherapy. With a median follow-up of 110 months for surviving patients, the 5-year overall and progression-free survival rates were 57% and 47%, respectively. 46 patients experienced local progression of disease during the follow-up period. In multivariate analysis, age at diagnosis, extent of surgery and post-operative Karnofsky performance status showed independent prognostic significance for progression-free and overall survival rates. Post-operative radiotherapy had independent prognostic value for progression-free survival. This analysis has changed our practice and we suggest that aggressive surgical resection and post-operative radiotherapy might be considered for patients with low-grade gliomas. Further efforts should be made to optimize radiotherapy techniques and to integrate new therapeutic modalities.
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: S-A
authors.initials: SA
authors.lastname: Yeh
authors.forename: J-T
authors.initials: JT
authors.lastname: Ho
authors.forename: C-C
authors.initials: CC
authors.lastname: Lui
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Huang
authors.forename: C-Y
authors.initials: CY
authors.lastname: Hsiung
authors.forename: E-Y
authors.initials: EY
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy / Q000379:methods; D018450:Disease Progression; D005260:Female; D005910:Glioma / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome