title: Adult patients with supratentorial pilocytic astrocytoma: long-term follow-up of prospective multicenter clinical trial NCCTG-867251 (Alliance).
abstract: BACKGROUND
  Pilocytic astrocytoma is a rare tumor in adults. This report is of a prospective clinical trial with long-term follow-up.
  
  
  METHODS
  Between 1986 and 1994, 20 eligible adults with supratentorial pilocytic astrocytomas were enrolled in a prospective intergroup trial of radiotherapy (RT) after biopsy (3 patients) or observation after gross (11 patients) or subtotal (6 patients) resection.
  
  
  RESULTS
  At the time of analysis (median follow-up, 20.8 years), 2 patients (10%) have died and 18 patients (90%) are alive. Neurologic and cognitive function were stable or improved over time for the majority of patients. No toxic effects of treatment or malignant transformations have been recorded at last follow-up. For the entire cohort the 20-year time to progression and overall survival rates are 95% and 90% respectively. The cause of death (2.2 and 16.1 years after enrollment) in both patients was unrelated to tumor although both were biopsy-only patients. One subtotally resected tumor progressed 1 month after enrollment requiringP32injection into an enlarging cyst. Because of further progression this patient required RT 18 months later. This patient is alive without evidence of progression 18 years after RT.
  
  
  CONCLUSIONS
  The long-term follow-up results of this prospective trial confirm that adults with pilocytic astrocytomas have a favorable prognosis with regard to survival and neurologic function. Close observation is recommended for adults with pilocytic astrocytomas, reserving RT for salvage, as the majority remain stable after gross or subtotal resection and no adjuvant therapy.
authors.affiliation: Department of Radiation Oncology , The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (P.D.B.); Department of Radiation Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (P.D.B.); Alliance Statistics and Data Center, Department of Health Sciences Research , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (S.K.A., X.W.C); Department of Neurology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (B.P.O.); Division of Anatomic Pathology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (C.G.); Department of Medical Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (E.G., J.C.B.); Delaware/Christiana Care CCOP , 4701 Ogletown-Stanton Rd Ste 1109, Newark, DE 19713 (S.A.S.); Department of Radiation Oncology , Rush University Medical Center , 500 S Paulina St Atrium Bldg Ground Floor, Chicago, IL 60612 (R.A.A.); Department of Radiation Oncology , Emory University School of Medicine , 1365 Clifton Rd NE Ste A-1358, Atlanta, GA 30322 (W.J.C.); Department of Radiation Oncology , Wake Forest University Medical Center , 2000 W. First St. Ste 101, Winston-Salem, NC 27104 (E.G.S.).
authors.forename: Paul D
authors.initials: PD
authors.lastname: Brown
authors.affiliation: Department of Radiation Oncology , The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (P.D.B.); Department of Radiation Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (P.D.B.); Alliance Statistics and Data Center, Department of Health Sciences Research , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (S.K.A., X.W.C); Department of Neurology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (B.P.O.); Division of Anatomic Pathology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (C.G.); Department of Medical Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (E.G., J.C.B.); Delaware/Christiana Care CCOP , 4701 Ogletown-Stanton Rd Ste 1109, Newark, DE 19713 (S.A.S.); Department of Radiation Oncology , Rush University Medical Center , 500 S Paulina St Atrium Bldg Ground Floor, Chicago, IL 60612 (R.A.A.); Department of Radiation Oncology , Emory University School of Medicine , 1365 Clifton Rd NE Ste A-1358, Atlanta, GA 30322 (W.J.C.); Department of Radiation Oncology , Wake Forest University Medical Center , 2000 W. First St. Ste 101, Winston-Salem, NC 27104 (E.G.S.).
authors.forename: S Keith
authors.initials: SK
authors.lastname: Anderson
authors.affiliation: Department of Radiation Oncology , The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (P.D.B.); Department of Radiation Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (P.D.B.); Alliance Statistics and Data Center, Department of Health Sciences Research , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (S.K.A., X.W.C); Department of Neurology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (B.P.O.); Division of Anatomic Pathology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (C.G.); Department of Medical Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (E.G., J.C.B.); Delaware/Christiana Care CCOP , 4701 Ogletown-Stanton Rd Ste 1109, Newark, DE 19713 (S.A.S.); Department of Radiation Oncology , Rush University Medical Center , 500 S Paulina St Atrium Bldg Ground Floor, Chicago, IL 60612 (R.A.A.); Department of Radiation Oncology , Emory University School of Medicine , 1365 Clifton Rd NE Ste A-1358, Atlanta, GA 30322 (W.J.C.); Department of Radiation Oncology , Wake Forest University Medical Center , 2000 W. First St. Ste 101, Winston-Salem, NC 27104 (E.G.S.).
authors.forename: Xiomara W
authors.initials: XW
authors.lastname: Carrero
authors.affiliation: Department of Radiation Oncology , The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (P.D.B.); Department of Radiation Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (P.D.B.); Alliance Statistics and Data Center, Department of Health Sciences Research , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (S.K.A., X.W.C); Department of Neurology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (B.P.O.); Division of Anatomic Pathology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (C.G.); Department of Medical Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (E.G., J.C.B.); Delaware/Christiana Care CCOP , 4701 Ogletown-Stanton Rd Ste 1109, Newark, DE 19713 (S.A.S.); Department of Radiation Oncology , Rush University Medical Center , 500 S Paulina St Atrium Bldg Ground Floor, Chicago, IL 60612 (R.A.A.); Department of Radiation Oncology , Emory University School of Medicine , 1365 Clifton Rd NE Ste A-1358, Atlanta, GA 30322 (W.J.C.); Department of Radiation Oncology , Wake Forest University Medical Center , 2000 W. First St. Ste 101, Winston-Salem, NC 27104 (E.G.S.).
authors.forename: Brian P
authors.initials: BP
authors.lastname: O'Neill
authors.affiliation: Department of Radiation Oncology , The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (P.D.B.); Department of Radiation Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (P.D.B.); Alliance Statistics and Data Center, Department of Health Sciences Research , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (S.K.A., X.W.C); Department of Neurology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (B.P.O.); Division of Anatomic Pathology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (C.G.); Department of Medical Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (E.G., J.C.B.); Delaware/Christiana Care CCOP , 4701 Ogletown-Stanton Rd Ste 1109, Newark, DE 19713 (S.A.S.); Department of Radiation Oncology , Rush University Medical Center , 500 S Paulina St Atrium Bldg Ground Floor, Chicago, IL 60612 (R.A.A.); Department of Radiation Oncology , Emory University School of Medicine , 1365 Clifton Rd NE Ste A-1358, Atlanta, GA 30322 (W.J.C.); Department of Radiation Oncology , Wake Forest University Medical Center , 2000 W. First St. Ste 101, Winston-Salem, NC 27104 (E.G.S.).
authors.forename: Caterina
authors.initials: C
authors.lastname: Giannini
authors.affiliation: Department of Radiation Oncology , The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (P.D.B.); Department of Radiation Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (P.D.B.); Alliance Statistics and Data Center, Department of Health Sciences Research , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (S.K.A., X.W.C); Department of Neurology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (B.P.O.); Division of Anatomic Pathology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (C.G.); Department of Medical Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (E.G., J.C.B.); Delaware/Christiana Care CCOP , 4701 Ogletown-Stanton Rd Ste 1109, Newark, DE 19713 (S.A.S.); Department of Radiation Oncology , Rush University Medical Center , 500 S Paulina St Atrium Bldg Ground Floor, Chicago, IL 60612 (R.A.A.); Department of Radiation Oncology , Emory University School of Medicine , 1365 Clifton Rd NE Ste A-1358, Atlanta, GA 30322 (W.J.C.); Department of Radiation Oncology , Wake Forest University Medical Center , 2000 W. First St. Ste 101, Winston-Salem, NC 27104 (E.G.S.).
authors.forename: Eva
authors.initials: E
authors.lastname: Galanis
authors.affiliation: Department of Radiation Oncology , The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (P.D.B.); Department of Radiation Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (P.D.B.); Alliance Statistics and Data Center, Department of Health Sciences Research , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (S.K.A., X.W.C); Department of Neurology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (B.P.O.); Division of Anatomic Pathology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (C.G.); Department of Medical Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (E.G., J.C.B.); Delaware/Christiana Care CCOP , 4701 Ogletown-Stanton Rd Ste 1109, Newark, DE 19713 (S.A.S.); Department of Radiation Oncology , Rush University Medical Center , 500 S Paulina St Atrium Bldg Ground Floor, Chicago, IL 60612 (R.A.A.); Department of Radiation Oncology , Emory University School of Medicine , 1365 Clifton Rd NE Ste A-1358, Atlanta, GA 30322 (W.J.C.); Department of Radiation Oncology , Wake Forest University Medical Center , 2000 W. First St. Ste 101, Winston-Salem, NC 27104 (E.G.S.).
authors.forename: Sunjay A
authors.initials: SA
authors.lastname: Shah
authors.affiliation: Department of Radiation Oncology , The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (P.D.B.); Department of Radiation Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (P.D.B.); Alliance Statistics and Data Center, Department of Health Sciences Research , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (S.K.A., X.W.C); Department of Neurology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (B.P.O.); Division of Anatomic Pathology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (C.G.); Department of Medical Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (E.G., J.C.B.); Delaware/Christiana Care CCOP , 4701 Ogletown-Stanton Rd Ste 1109, Newark, DE 19713 (S.A.S.); Department of Radiation Oncology , Rush University Medical Center , 500 S Paulina St Atrium Bldg Ground Floor, Chicago, IL 60612 (R.A.A.); Department of Radiation Oncology , Emory University School of Medicine , 1365 Clifton Rd NE Ste A-1358, Atlanta, GA 30322 (W.J.C.); Department of Radiation Oncology , Wake Forest University Medical Center , 2000 W. First St. Ste 101, Winston-Salem, NC 27104 (E.G.S.).
authors.forename: Ross A
authors.initials: RA
authors.lastname: Abrams
authors.affiliation: Department of Radiation Oncology , The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (P.D.B.); Department of Radiation Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (P.D.B.); Alliance Statistics and Data Center, Department of Health Sciences Research , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (S.K.A., X.W.C); Department of Neurology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (B.P.O.); Division of Anatomic Pathology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (C.G.); Department of Medical Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (E.G., J.C.B.); Delaware/Christiana Care CCOP , 4701 Ogletown-Stanton Rd Ste 1109, Newark, DE 19713 (S.A.S.); Department of Radiation Oncology , Rush University Medical Center , 500 S Paulina St Atrium Bldg Ground Floor, Chicago, IL 60612 (R.A.A.); Department of Radiation Oncology , Emory University School of Medicine , 1365 Clifton Rd NE Ste A-1358, Atlanta, GA 30322 (W.J.C.); Department of Radiation Oncology , Wake Forest University Medical Center , 2000 W. First St. Ste 101, Winston-Salem, NC 27104 (E.G.S.).
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Curran
authors.affiliation: Department of Radiation Oncology , The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (P.D.B.); Department of Radiation Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (P.D.B.); Alliance Statistics and Data Center, Department of Health Sciences Research , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (S.K.A., X.W.C); Department of Neurology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (B.P.O.); Division of Anatomic Pathology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (C.G.); Department of Medical Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (E.G., J.C.B.); Delaware/Christiana Care CCOP , 4701 Ogletown-Stanton Rd Ste 1109, Newark, DE 19713 (S.A.S.); Department of Radiation Oncology , Rush University Medical Center , 500 S Paulina St Atrium Bldg Ground Floor, Chicago, IL 60612 (R.A.A.); Department of Radiation Oncology , Emory University School of Medicine , 1365 Clifton Rd NE Ste A-1358, Atlanta, GA 30322 (W.J.C.); Department of Radiation Oncology , Wake Forest University Medical Center , 2000 W. First St. Ste 101, Winston-Salem, NC 27104 (E.G.S.).
authors.forename: Jan C
authors.initials: JC
authors.lastname: Buckner
authors.affiliation: Department of Radiation Oncology , The University of Texas MD Anderson Cancer Center , 1515 Holcombe Blvd, Unit 97, Houston, TX 77030 (P.D.B.); Department of Radiation Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (P.D.B.); Alliance Statistics and Data Center, Department of Health Sciences Research , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (S.K.A., X.W.C); Department of Neurology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (B.P.O.); Division of Anatomic Pathology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (C.G.); Department of Medical Oncology , Mayo Clinic , 200 SW 1st St, Rochester, MN 55905 (E.G., J.C.B.); Delaware/Christiana Care CCOP , 4701 Ogletown-Stanton Rd Ste 1109, Newark, DE 19713 (S.A.S.); Department of Radiation Oncology , Rush University Medical Center , 500 S Paulina St Atrium Bldg Ground Floor, Chicago, IL 60612 (R.A.A.); Department of Radiation Oncology , Emory University School of Medicine , 1365 Clifton Rd NE Ste A-1358, Atlanta, GA 30322 (W.J.C.); Department of Radiation Oncology , Wake Forest University Medical Center , 2000 W. First St. Ste 101, Winston-Salem, NC 27104 (E.G.S.).
authors.forename: Edward G
authors.initials: EG
authors.lastname: Shaw
keywords: pilocytic astrocytoma; prospective; radiotherapy; resection