A randomized trial on dose-response in radiation therapy of low-grade cerebral glioma: European organization for research and treatment of cancer (EORTC) study 22844
A randomized trial on dose-response in radiation therapy of low-grade cerebral glioma: European organization for research and treatment of cancer (EORTC) study 22844
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DOI：
10.1016/s0360-3016(96)00352-5
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发表时间：
1996-10-01
影响因子：
7
通讯作者：
Fabrini, MG
中科院分区：
文献类型：
--
作者：
Karim, ABMF;Maat, B;Fabrini, MG
目的：成人脑低级别胶质瘤（LGG）主要由星形细胞瘤、少突胶质细胞瘤和混合性少突星形细胞瘤组成。目前这些肿瘤的治疗政策尚未达成共识。我们试图在欧洲癌症研究与治疗组织 (EORTC) 进行的两项多中心随机试验中确定放疗的疗效以及这些肿瘤是否存在剂量反应关系。剂量反应研究是本文的主题。 方法和材料：在剂量反应试验中，379 名患有脑 LGG 的成年患者在 EORTC 数据中心被随机分配，接受术后（或活检后）5 周内 45 Gy 或 6.6 周内 59.4 Gy 的放射治疗，并接受质量控制放射治疗。前瞻性记录所有可能影响预后的已知参数。推荐采用传统治疗技术。结果：对 343 名符合条件且可评估的患者进行了至少 50 个月的随访，中位数为 74 个月，试验的两个组之间的生存率（低剂量组为 58%，高剂量组为 59%）或无进展生存期（47% 和 50%）没有显着差异。但是，这项前瞻性试验揭示了有关预后的一些重要方面。参数：协议中提出的 TNM 分类的 T 似乎是多变量分析中最重要的预后因素之一 (p < 0.0001)。其他预后因素（其中大多数是已知的）现已在这项前瞻性研究中得到量化和证实。结论：EORTC 试验 22844 尚未揭示 LGG 患者对于使用此常规设置研究的两个剂量水平是否存在放射治疗剂量反应，但客观预后参数已得到认可。本研究中使用的肿瘤大小或 T 参数似乎是一个非常重要的因素。版权所有 (C) 1996 爱思唯尔科学公司。
Purpose: Cerebral low-grade gliomas (LGG) in adults are mostly composed of astrocytomas, oligodendrogliomas, and mixed oligoastrocytomas. There is at present no consensus in the policy of treatment of these tumors. We sought to determine the efficacy of radiotherapy and the presence of a dose-response relationship for these tumors in two multicentric randomized trials conducted by the European Organization for Research and Treatment of Cancer (EORTC). The dose-response study is the subject of this article.Methods and Materials: For the dose-response trial, 379 adult patients with cerebral LGGs were randomized centrally at the EORTC Data Center to receive irradiation postoperatively (or postbiopsy) with either 45 Gy in 5 weeks or 59.4 Gy in 6.6 weeks with quality-controlled radiation therapy. All known parameters with possible influences on prognosis were prospectively recorded. Conventional treatment techniques were recommended.Results: With 343 (91%) eligible and evaluable patients followed up for at least 50 months with a median of 74 months, there is no significant difference in terms of survival (58% for the low-dose arm and 59% for the high-dose arm) or the progression free survival (47% and 50%) between the two arms of the trial However, this prospective trial has revealed some important facets about the prognostic parameters: The T of the TNM classifications as proposed in the protocol appears to be one of the most important prognostic factors (p < 0.0001) on multivariate analysis. Other prognostic factors, most of which are known, have now been quantified and confirmed in this prospective study.Conclusion: The EORTC trial 22844 has not revealed the presence of radiotherapeutic dose-response for patients with LGG for the two dose levels investigated with this conventional setup, but objective prognostic parameters are recognized. The tumor size or T parameter as used in this study appears to be a very important factor. Copyright (C) 1996 Elsevier Science Inc.