Postoperative radiotherapy results in primary spinal cord astrocytomas

Abstract

Background and purpose: We retrospectively evaluated the therapeutic outcomes of patients with primary spinal cord astrocytomas treated with conventional radiotherapy at our institute.

Patients and methods: Between May 1975 and December 1997, 26 patients with histologically proven spinal cord astrocytomas were treated with conventional radiotherapy, and twenty-four eligible patients were evaluated. Median age was 19 years (2-41 years). Fourteen of astrocytomas were grade I, 6 of them grade II and 4 grade III. Ten patients had subtotal excision, and 14 had only biopsy of the primary lesion. Patients were treated with 1-2 Gy daily fractions, and given to a median total dose of 49.5 Gy (range 35-60 Gy) external radiotherapy to primary tumor.

Results: Median follow-up was 39 months. Seventeen patients died of their disease. Two patients have progression, and 5 patients are followed with stabile disease. Five-year overall survival was 45% and progression free survival was 40%. Among the analyzed factors only gender and age were found to be significant.

Conclusions: Our results are slightly worse than previous retrospective radiotherapy series in the literature. With new imaging and radiation therapy techniques, radiotherapy may have a role as an adjuvant treatment especially in subtotally resected tumors.