Postoperative irradiation of incompletely excised gemistocytic astrocytomas. Clinical outcome and prognostic factors.
OBJECTIVE
Although gemistocytic astrocytomas are considered slow-growing tumors, they often behave aggressively and carry the least favorable prognosis among low-grade astrocytomas. The aim of this study is to evaluate the outcomes and prognostic factors of patients with incompletely excised gemistocytic astrocytomas irradiated postoperatively.


METHODS
Records of 48 patients with incompletely excised gemistocytic astrocytoma, irradiated between 1976 and 1998 at the Department of Radiation Oncology, Maria Skłodowska-Curie Memorial Cancer Center, Cracow, Poland, were reviewed. The total dose ranged from 50 to 60 Gy (mean: 59.35, median: 60 Gy) delivered in daily fractions of 2 Gy, 5 days a week. The treatment volume covered the residual tumor with a margin of 1-2 cm.


RESULTS
Toxicity was acceptable. The overall actuarial survival rates at 5 and 10 years were 30% and 17%, respectively. Age and gender had an influence on overall survival by univariate and multivariate analysis (p < 0.05). Patients < or = 35 years of age and female patients carried the best prognosis.


CONCLUSIONS
In most patients with gemistocytic astrocytoma, combined surgery and postoperative radiotherapy result in only short-term survival. Older age is the most important unfavorable prognostic factor in patients with gemistocytic astrocytoma.
Nowak-Sadzikowska
Jadwiga
J
Department of Radiation Oncology, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, 11 Garncarska Street, 31-115 Kraków, Poland. z5sadzik@cyf-kr.edu.pl
Gliński
Bogdan
B
Szpytma
Teresa
T
Pluta
Elzbieta
E
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D001254:Astrocytoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D001932:Brain Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors