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Randomized Controlled Trial
. 2011 Sep 1;81(1):218-24.
doi: 10.1016/j.ijrobp.2010.05.003. Epub 2011 May 5.

Validation of EORTC prognostic factors for adults with low-grade glioma: a report using intergroup 86-72-51

Thomas B Daniels  1 , Paul D Brown, Sara J Felten, Wenting Wu, Jan C Buckner, Robert M Arusell, Walter J Curran, Ross A Abrams, David Schiff, Edward G Shaw
Affiliations
Randomized Controlled Trial

Validation of EORTC prognostic factors for adults with low-grade glioma: a report using intergroup 86-72-51

Thomas B Daniels et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: A prognostic index for survival was constructed and validated from patient data from two European Organisation for Research and Treatment of Cancer (EORTC) radiation trials for low-grade glioma (LGG). We sought to independently validate this prognostic index with a separate prospectively collected data set (Intergroup 86-72-51).

Methods and materials: Two hundred three patients were treated in a North Central Cancer Treatment Group-led trial that randomized patients with supratentorial LGG to 50.4 or 64.8 Gy. Risk factors from the EORTC prognostic index were analyzed for prognostic value: histology, tumor size, neurologic deficit, age, and tumor crossing the midline. The high-risk group was defined as patients with more than two risk factors. In addition, the Mini Mental Status Examination (MMSE) score, extent of surgical resection, and 1p19q status were also analyzed for prognostic value.

Results: On univariate analysis, the following were statistically significant (p<0.05) detrimental factors for both progression-free survival (PFS) and overall survival (OS): astrocytoma histology, tumor size, and less than total resection. A Mini Mental Status Examination score of more than 26 was a favorable prognostic factor. Multivariate analysis showed that tumor size and MMSE score were significant predictors of OS whereas tumor size, astrocytoma histology, and MMSE score were significant predictors of PFS. Analyzing by the EORTC risk groups, we found that the low-risk group had significantly better median OS (10.8 years vs. 3.9 years, p<0.0001) and PFS (6.2 years vs. 1.9 years, p<0.0001) than the high-risk group. The 1p19q status was available in 66 patients. Co-deletion of 1p19q was a favorable prognostic factor for OS vs. one or no deletion (median OS, 12.6 years vs. 7.2 years; p=0.03).

Conclusions: Although the low-risk group as defined by EORTC criteria had a superior PFS and OS to the high-risk group, this is primarily because of the influence of histology and tumor size. Co-deletion of 1p19q is a prognostic factor. Future studies are needed to develop a more refined prognostic system that combines clinical prognostic features with more robust molecular and genetic data.

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Conflict of interest statement

Conflict of Interest Notification: None

Figures

Figure 1
Figure 1
Overall Survival (in years) by Prognostic Score
Figure 2
Figure 2
Kaplan-Meier Curves and Comparison for Overall Survival for Risk Groups Defined Solely by Size and Histology
Figure 3
Figure 3
Kaplan-Meier Curves and Comparison for Progression-Free Survival for Risk Groups Defined Solely by Size and Histology
Figure 4
Figure 4
Overall Survival for 66 Patients with 1p19q Deletion Status Available
See this image and copyright information in PMC

References

    1. Bauman G, Lote K, Larson D, et al. Pretreatment factors predict overall survival for patients with low-grade glioma: a recursive partitioning analysis. Int J Radiat Oncol Biol Phys. 1999 Nov 1;45(4):923–929. - PubMed
    1. Leighton C, Fisher B, Bauman G, et al. Supratentorial low-grade glioma in adults: an analysis of prognostic factors and timing of radiation. J Clin Oncol. 1997 Apr;15(4):1294–1301. - PubMed
    1. Karim AB, Maat B, Hatlevoll R, et al. 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. Int J Radiat Oncol Biol Phys. 1996 Oct 1;36(3):549–556. - PubMed
    1. Karim AB, Afra D, Cornu P, et al. Randomized trial on the efficacy of radiotherapy for cerebral low-grade glioma in the adult: European Organization for Research and Treatment of Cancer Study 22845 with the Medical Research Council study BRO4: an interim analysis. Int J Radiat Oncol Biol Phys. 2002 Feb 1;52(2):316–324. - PubMed
    1. van den Bent MJ, Afra D, de Witte O, et al. Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial. Lancet. 2005;366(9490):985–990. - PubMed

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