Patterns of practice and survival in a retrospective analysis of 1722 adult astrocytoma patients treated between 1985 and 2001 in 12 Italian radiation oncology centers
- Department of Radiation Oncology, University of Brescia, Brescia (Italy)
- Department of Radiation Oncology, University of Turin, Turin (Italy)
- Section of Radiation Oncology, Department of Biopathology and Imaging, University of Tor Vergata, Rome (Italy)
- Department of Radiation Oncology, University of Piemonte Orientale, Novara (Italy)
- Department of Radiation Oncology, University of Perugia, Perugia (Italy)
- Department of Radiation Oncology, Istituti Ospitalieri, Cremona (Italy)
- Department of Radiation Oncology, University of Florence, Florence (Italy)
- Department of Radiation Oncology, S. Donato Hospital, Arezzo (Italy)
- Department of Radiation Oncology, Policlinico di Modena, Modena (Italy)
- Department of Radiation Oncology, University La Sapienza, Rome (Italy)
- Department of Radiation Oncology, University of L'Aquila, L'Aquila (Italy)
- Section of Oncologic Radiology and Radiotherapy, Department of Human Pathology and Oncology, University of Siena, Siena (Italy)
Purpose: To analyze the patterns of practice and survival in a series of 1722 adult astrocytoma patients treated in 12 Italian radiotherapy centers. Methods and Materials: A total of 1722 patients were treated with postoperative radiotherapy (90% World Health Organization [WHO] Grade 3-4, 62% male, 44% aged >60 years, 25% with severe neurologic deficits, 44% after gross total resection, 52% with high-dose radiotherapy, and 16% with chemotherapy). Variations in the clinical-therapeutic features in three subsequent periods (1985 through 2001) were evaluated, along with overall survival for the different subgroups. Results: The proportion of women, of older patients, of those with worse neurologic performance status (NPS), with WHO Grade 4, and with smaller tumors increased with time, as did the proportion of those treated with radical surgery, hypofractionated radiotherapy, and more sophisticated radiotherapy techniques, after staging procedures progressively became more accurate. The main prognostic factors for overall survival were age, sex, neurologic performance status, WHO grade, extent of surgery, and radiation dose. Conclusions: Recently, broader selection criteria for radiotherapy were adopted, together with simpler techniques, smaller total doses, and larger fraction sizes for the worse prognostic categories. Younger, fit patients are treated more aggressively, more often in association with chemotherapy. Survival did not change over time. The accurate evaluation of neurologic status is therefore of utmost importance before the best treatment option for the individual patient is chosen.
- OSTI ID:
- 20842911
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 65, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2006.01.026; PII: S0360-3016(06)00174-X; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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