Generation and validation of a prognostic score to predict outcome after re-irradiation of recurrent glioma
Combs SE, Edler L, Rausch R, Welzel T, Wick W, Debus J (2013)
Publication Type: Journal article
Publication year: 2013
Journal
Book Volume: 52
Pages Range: 147-152
Journal Issue: 1
DOI: 10.3109/0284186X.2012.692882
Abstract
Re-irradiation using high-precision radiation techniques has been established within the clinical routine for patients with recurrent gliomas. In the present work, we developed a practical prognostic score to predict survival outcome after re-irradiation. Patients and methods. Fractionated stereotactic radiotherapy (FSRT) was applied in 233 patients. Primary histology included glioblastoma (n =89; 38%), WHO Grade III gliomas (n = 52; 22%) and low-grade glioma (n =92; 40%). FSRT was applied with a median dose of 36 Gy in 2 Gy single fractions. We evaluated survival after re-irradiation as well as progression-free survival after re-irradiation; prognostic factors analyzed included age, tumor volume at re-irradiation, histology, time between initial radiotherapy and re-irradiation, age and Karnofsky Performance Score. Results. Median survival after FSRT was 8 months for glioblastoma, 20 months for anaplastic gliomas, and 24 months for recurrent low-grade patients. The strongest prognostic factors significantly impacting survival after re-irradiation were histology (p <0.0001) and age (<50 vs. ≥50, p <0.0001) at diagnosis and the time between initial radiotherapy and re-irradiation ≤12 vs. >12 months (p <0.0001). We generated a four-class prognostic score to distinguish patients with excellent (0 points), good (1 point), moderate (2 points) and poor (3-4 points) survival after re-irradiation. The difference in outcome was highly significant (p <0.0001). Conclusion. We generated a practical prognostic score index based on three clinically relevant factors to predict the benefit of patients from re-irradiation. This score index can be helpful in patient counseling, and for the design of further clinical trials. However, individual treatment decisions may include other patient-related factors not directly influencing outcome. © 2013 Informa Healthcare.
Involved external institutions
Germany (DE)How to cite
APA:
Combs, S.E., Edler, L., Rausch, R., Welzel, T., Wick, W., & Debus, J. (2013). Generation and validation of a prognostic score to predict outcome after re-irradiation of recurrent glioma. Acta Oncologica, 52(1), 147-152. https://doi.org/10.3109/0284186X.2012.692882
MLA:
Combs, Stephanie E., et al. "Generation and validation of a prognostic score to predict outcome after re-irradiation of recurrent glioma." Acta Oncologica 52.1 (2013): 147-152.
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