Generation and validation of a prognostic score to predict outcome after re-irradiation of recurrent glioma

• Verfasst von: Combs, Stephanie [VerfasserIn]
• Verfasst von: Edler, Lutz [VerfasserIn]
• Verfasst von: Welzel, Thomas [VerfasserIn]
• Verfasst von: Wick, Wolfgang [VerfasserIn]
• Verfasst von: Debus, Jürgen [VerfasserIn]
• Titel: Generation and validation of a prognostic score to predict outcome after re-irradiation of recurrent glioma
• Verf.angabe: Stephanie E. Combs, Lutz Edler, Renate Rausch, Thomas Welzel, Wolfgang Wick & Jürgen Debus
• Jahr: 2013
• Jahr des Originals: 2012
• Umfang: 6 S.
• Fussnoten: Published online: 11 Jun 2012 ; Gesehen am 29.08.2018
• Titel Quelle: Enthalten in: Acta oncologica
• Ort Quelle: Abingdon : Taylor & Francis Group, 1987
• Jahr Quelle: 2013
• Band/Heft Quelle: 52(2013), 1, Seite 147-152
• ISSN Quelle: 1651-226X
• DOI: doi:10.3109/0284186X.2012.692882
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1580486088

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.