title: Long-term follow-up in adult patients with low-grade glioma (WHO II) postoperatively irradiated. Analysis of prognostic factors.
abstract: OBJECTIVE
  To report the long-term follow-up of a cohort of adult patients with LGG post-operatively irradiated in one institution, and to identify prognostic factors for progression free survival.
  
  
  BACKGROUND
  There is little consensus about the optimal treatment for low-grade glioma (LGG), and the clinical management of LGG is one of the most controversial areas in neurooncology. Radiation therapy is one option for treatment of patients with LGG, whereas other options include postoperative observation.
  
  
  METHODS
  Between 1975 and 2005, 180 patients with LGG (WHO II) received postoperative irradiation after non radical (subtotal or partial) excision. Patients had to be 18 years of age or older, and have histologic proof of supratentorial fibrillary (FA), protoplasmic (PA) or gemistocytic astrocytoma (GA). Radiotherapy was given within 3-10 weeks after surgery. Treatment fields were localized and included the preoperative tumor volume, with a 1-2 cm margin, treated to a total dose of 50-60 Gy in 25-30 fractions over 5-6 weeks.
  
  
  RESULTS
  Actuarial ten-year progression free survival (APFS) in the whole group was 19%. The worse prognosis was observed in patients with GA. Ten-year APFS rates for GA, PA and FA were 10%, 18% and 22%, respectively.
  
  
  CONCLUSIONS
  The findings from our long-term cohort of 180 patients with LGG confirmed by uni- and multivariate analysis demonstrated that only astrocytoma histology significantly determined the prognosis. The best survival was observed in patients with the fibrillary variant, and the worst for the gemistocytic one.
authors.affiliation: Head and Neck Cancer Department, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Mucha-Małecka
authors.affiliation: Head and Neck Cancer Department, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Gliński
authors.affiliation: Head and Neck Cancer Department, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Hetnał
authors.affiliation: Head and Neck Cancer Department, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Jarosz
authors.affiliation: Head and Neck Cancer Department, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Urbański
authors.affiliation: Head and Neck Cancer Department, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Frączek-Błachut
authors.affiliation: Head and Neck Cancer Department, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Dymek
authors.affiliation: Head and Neck Cancer Department, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Małecki
authors.affiliation: Head and Neck Cancer Department, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Chrostowska
keywords: Low-grade gliomas; Radiotherapy; Surgery