Therapy for supratentorial malignant astrocytomas: survival and possible prognostic factors

Abstract

Maximum feasible resection of the tumor followed by 50 Gy whole brain irradiation was the routine management for patients with malignant glioma in this series. To determine treatment results and possible prognostic factors, a retrospective analysis was done of 116 patients with pathologically proven supratentorial malignant astrocytomas (71 glioblastoma multiforme and 45 anaplastic astrocytoma) from January 1981 to December 1990. The mean age of the patients at the time of diagnosis was 46 years for glioblastoma multiforme and 37 years for anaplastic astrocytoma. In 86% of the patients, their condition improved or was constant after surgery; in 14% of the patients, the conditions worsened. The median survival time was 10 months for patients with glioblastoma multiforme and 22 months for those with anaplastic astrocytoma. Cox regression analysis showed that the duration of symptoms, extent of resection, irradiation and tumor histology were significantly related to the survival time. However, gross total resection did not improve the survival time relative to a subtotal resection, although both were shown to be better than a partial resection or biopsy.