title: Malignant glioma grade 3 and 4: how relevant is timing of radiotherapy?
abstract: OBJECTIVE
  The aim of this study is to determine prognostic factors that influence further outcome in patients with glioma.
  
  
  METHODS
  Between 01/2002 and 08/2008, 153 patients with malignant gliomas of WHO-grade 3 or 4 who were treated with external beam radiotherapy with or without chemotherapy.
  
  
  RESULTS
  In univariate analysis, following factors were ascertained as statistically significant prognostic parameters: grade (p = 0.000), time between operation and radiotherapy >24 days (p = 0.044) for progression-free survival; grade (p = 0.000), age<58 years (p = 0.001), extent of surgery (p = 0.011), time between operation and radiotherapy >24 days (p = 0.009), overall treatment time >68 days (p = 0.003), use of chemotherapy (p = 0.015) for overall survival. A longer time period between resection and start of radiotherapy showed to be associated with improved outcome. After multivariate analysis, only grade (p = 0.000) remained a statistically significant factor for progression-free and grade (p = 0.000) and use of chemotherapy (p = 0.031) for overall survival.
  
  
  CONCLUSIONS
  We were able to recognize grade and use of chemotherapy as statistically significant prognostic determinants, but not time intervals or overall treatment time.
authors.affiliation: Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany.
authors.forename: Friederike M
authors.initials: FM
authors.lastname: Wehming
authors.forename: Bettina
authors.initials: B
authors.lastname: Wiese
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakamura
authors.forename: Michael
authors.initials: M
authors.lastname: Bremer
authors.forename: Johann H
authors.initials: JH
authors.lastname: Karstens
authors.forename: Andreas
authors.initials: A
authors.lastname: Meyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001254:Astrocytoma / Q000000981:diagnostic imaging; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000532:radiotherapy; D005910:Glioma / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019635:Neurosurgical Procedures; D009837:Oligodendroglioma / Q000000981:diagnostic imaging; D011379:Prognosis; D011859:Radiography; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents