title: Factors predicting recurrence in patients with grade III glial tumors: impact of adjuvant temozolomide on recurrence.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the clinicopathological features of patients with grade III glial tumors associated with recurrence after treatment.
  
  
  METHODS
  A retrospective analysis was carried out on 67 patients with grade III glial tumors between May 2007 and June 2013. Data were retrieved from patient electronic medical records and paper charts.
  
  
  RESULTS
  The patient median age was 43 years (range 19-707 rpar;. Of these, 50.7% (N=34) had anaplastic astrocytoma, 29.9% (N=20) anaplastic oligoastrocytoma and 19.4% (N=13) anaplastic oligodendroglioma. Among these 67 patients, 41 (61.2%) developed local recurrence. Fifty seven of them (80.6%) received radiotherapy (RT) with concomitant temozolomide. Of these patients, 14 (20.9%) received RT with concomitant temozolomide alone, and 43 (64.2%) were treated with concomitant chemoradiotherapy followed by adjuvant temozolomide. Time to recurrence (TTR) of patients who received adjuvant temozolomide after concomitant chemoradiation (TTR=14 months, 95% CI 9.3-22.77 rpar; as initial treatment for grade III glial tumors was not superior to RT with concomitant temozolomide alone (TTR=21 months, 95% CI 14.8-35.2; p=0.224) In multivariate analysis, histologic subtype (p=0.015), age (p=0.019) and presence of neurologic symptoms (p=0.021) were independent predictive factors of recurrence.
  
  
  CONCLUSIONS
  This analysis demonstrated that histologic subtype, age and presence of neurologic symptoms were significantly associated with recurrence in patients with grade III glial tumors. Adjuvant temozolomide was not significantly associated with recurrence in patients with grade III glial tumors. The identification of these predictors may be important for the patient follow-up and better treatment modifications.
authors.affiliation: Department of Internal Medicine, Division of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ozge
authors.initials: O
authors.lastname: Gumusay
authors.forename: Bulent
authors.initials: B
authors.lastname: Cetin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozet
authors.forename: Umut
authors.initials: U
authors.lastname: Demirci
authors.forename: Suleyman
authors.initials: S
authors.lastname: Buyukberber
authors.forename: Ugur
authors.initials: U
authors.lastname: Coskun
authors.forename: Efnan
authors.initials: E
authors.lastname: Algin
authors.forename: Aytug
authors.initials: A
authors.lastname: Uner
authors.forename: Ramazan
authors.initials: R
authors.lastname: Yildiz
authors.forename: Gokhann
authors.initials: G
authors.lastname: Kurt
authors.forename: Mustafa
authors.initials: M
authors.lastname: Benekli
mesh_terms: D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001254:Astrocytoma; D001932:Brain Neoplasms / Q000188:drug therapy*; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005910:Glioma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D009837:Oligodendroglioma; D012189:Retrospective Studies; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide