title: Radiotherapy and temozolomide in anaplastic astrocytoma: a retrospective multicenter study by the Central Nervous System Study Group of AIRO (Italian Association of Radiation Oncology).
abstract: Although the evidence for the benefit of adding temozolomide (TMZ) to radiotherapy (RT) is limited to glioblastoma patients, there is currently a trend toward treating anaplastic astrocytomas (AAs) with combined RT + TMZ. The aim of the present study was to describe the patterns of care of patients affected by AA and, particularly, to compare the outcome of patients treated exclusively with RT with those treated with RT + TMZ. Data of 295 newly diagnosed AAs treated with postoperative RT ± TMZ in the period from 2002 to 2007 were reviewed. More than 75% of patients underwent a surgical removal. All the patients had postoperative RT; 86.1% of them were treated with 3D-conformal RT (3D-CRT). Sixty-seven percent of the entire group received postoperative chemotherapy with TMZ (n = 198). One-hundred sixty-six patients received both concomitant and sequential TMZ. Prescription of postoperative TMZ increased in the most recent period (2005-2007). One- and 4-year survival rates were 70.2% and 28.6%, respectively. No statistically significant improvement in survival was observed with the addition of TMZ to RT (P = .59). Multivariate analysis showed the statistical significance of age, presence of seizures, Recursive Partitioning Analysis classes I-III, extent of surgical removal, and 3D-CRT. Changes in the care of AA over the past years are documented. Currently there is not evidence to justify the addition of TMZ to postoperative RT for patients with newly diagnosed AA outside a clinical trial. Results of prospective and randomized trials are needed.
authors.affiliation: Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, Viale Morgagni 85, 50134 Florence, Italy. silvia.scoccianti@unifi.it
authors.forename: Silvia
authors.initials: S
authors.lastname: Scoccianti
authors.forename: Stefano Maria
authors.initials: SM
authors.lastname: Magrini
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
authors.forename: Beatrice
authors.initials: B
authors.lastname: Detti
authors.forename: Marco
authors.initials: M
authors.lastname: Krengli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Parisi
authors.forename: Filippo
authors.initials: F
authors.lastname: Bertoni
authors.forename: Guido
authors.initials: G
authors.lastname: Sotti
authors.forename: Samantha
authors.initials: S
authors.lastname: Cipressi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tombolini
authors.forename: Stefano
authors.initials: S
authors.lastname: Dall'oglio
authors.forename: Marco
authors.initials: M
authors.lastname: Lioce
authors.forename: Calogero
authors.initials: C
authors.lastname: Saieva
authors.forename: Michela
authors.initials: M
authors.lastname: Buglione
authors.forename: Cristina
authors.initials: C
authors.lastname: Mantovani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rubino
authors.forename: Paolo
authors.initials: P
authors.lastname: Muto
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fusco
authors.forename: Laura
authors.initials: L
authors.lastname: Fariselli
authors.forename: Costantino
authors.initials: C
authors.lastname: de Renzis
authors.forename: Laura
authors.initials: L
authors.lastname: Masini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Santoni
authors.forename: Luigi
authors.initials: L
authors.lastname: Pirtoli
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Biti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009837:Oligodendroglioma / Q000401:mortality / Q000628:therapy*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D000077204:Temozolomide; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide