title: Postoperative radiation therapy for low-grade glioma: patterns of care between 1998 and 2006.
abstract: BACKGROUND
  The role of postoperative radiotherapy (PORT) in the management of low-grade glioma remains controversial. An analysis using data from the European Organization for Research and Treatment of Cancer 22844/22845 studies concluded that several factors portend a poor prognosis: age ≥40 years, astrocytoma histology, tumor size ≥6 cm, tumor crossing midline, and preoperative neurologic deficits. PORT may benefit patients with high-risk features. The aim of this study was to assess temporal trends and determinants of the use of PORT.
  
  
  METHODS
  By using data from the Surveillance, Epidemiology, and End Results program, the authors identified 1127 adult patients diagnosed with low-grade glioma (World Health Organization grade I and II) who underwent surgical resection between January 1, 1998 and December 31, 2006. The primary outcome was receipt of PORT. The authors performed multivariate logistic regression to examine the association between clinical, patient, and demographic characteristics and receipt of PORT.
  
  
  RESULTS
  Receipt of PORT declined during the study period, from 64% of patients in 1998 to 36% of patients in 2006. On multivariate analysis, significant predictors of receipt of PORT were age ≥40 years, tumor crossing midline, and partial surgical resection.
  
  
  CONCLUSIONS
  The use of PORT for patients with low-grade glioma has declined in the period from 1998 to 2006 for both low-risk and high-risk patients.
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA. suneja@uphs.upenn.edu
authors.forename: Gita
authors.initials: G
authors.lastname: Suneja
authors.forename: Michelle
authors.initials: M
authors.lastname: Alonso-Basanta
authors.forename: Robert
authors.initials: R
authors.lastname: Lustig
authors.forename: John Y K
authors.initials: JY
authors.lastname: Lee
authors.forename: Justin E
authors.initials: JE
authors.lastname: Bekelman
mesh_terms: D000328:Adult; D000367:Age Factors; D001932:Brain Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005910:Glioma / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D011184:Postoperative Period; D018714:Radiotherapy, Adjuvant / Q000639:trends*; D016896:Treatment Outcome; D014481:United States