SURVIVAL IN PATIENTS WITH RECURRENT GLIOMA AS A MEASURE OF TREATMENT EFFICACY - PROGNOSTIC FACTORS FOLLOWING NITROSOUREA CHEMOTHERAPY

被引:65
作者
RAJAN, B
ROSS, G
LIM, CC
ASHLEY, S
GOODE, D
TRAISH, D
BRADA, M
机构
[1] ROYAL MARSDEN HOSP,NEUROONCOL UNIT,SUTTON SM2 5PT,SURREY,ENGLAND
[2] ROYAL MARSDEN HOSP,ACAD UNIT RADIOTHERAPY & ONCOL,SUTTON SM2 5PT,SURREY,ENGLAND
[3] ROYAL MARSDEN HOSP,DEPT COMP,SUTTON SM2 5PT,SURREY,ENGLAND
[4] INST CANC RES,SUTTON SM2 5PT,SURREY,ENGLAND
[5] REG CANC CTR,DEPT RADIOTHERAPY & ONCOL,TRIVANDRUM 695011,KERALA,INDIA
[6] POOLE GEN HOSP,DEPT RADIOTHERAPY & ONCOL,POOLE BH15 2JB,DORSET,ENGLAND
关键词
RECURRENT GLIOMA; CHEMOTHERAPY; PROGNOSTIC FACTORS;
D O I
10.1016/0959-8049(94)00248-4
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The assessment of efficacy of treatment in patients with recurrent glioma is notoriously difficult, and survival is the most objective endpoint. Between 1970 and 1992, a cohort of 211 patients with recurrent glioma received nitrosourea-based chemotherapy at the time of disease progression. The median survival from the start of chemotherapy was 7 months, with 30% 1-year and 10% 2-year survival probabilities. One-year survival was 22% in 147 patients with recurrent high-grade astrocytoma, 41% in 37 patients with low-grade astrocytoma and 45% in 24 patients with oligodendroglioma. Age, histological grade and Karnofsky performance status (KPS) at recurrence were independent prognostic factors for survival on multivariate analysis. Based on patients' age, tumour grade and KPS, it was possible to define three distinct prognostic groups with 1-year survival probabilities of 60, 21 and 17% (P < 0.005). Response to chemotherapy was difficult to assess but correlated with prognostic subgroup, with highest response rate (46%) in the most favourable group and lowest (13%) in the poor prognostic group. In patients with recurrent glioma, patient and tumour parameters are the major determinants of outcome which are identical to prognostic factors at the time of primary diagnosis. They can be used td provide prognostic information for the individual patient, and to stratify patients particularly in trials assessing the efficacy of novel treatments.
引用
收藏
页码:1809 / 1815
页数:7
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