뇌 성상세포종 환자의 외부 방사선치료External Beam Radiotherapy in the Management of Low Grade Astrocytoma of the Brain
- Other Titles
- External Beam Radiotherapy in the Management of Low Grade Astrocytoma of the Brain
- Authors
- Chun, Ha Chung
- Issue Date
- Mar-2009
- Publisher
- 대한방사선종양학회
- Keywords
- Radiotherapy; Low-grade astrocytoma; 방사선 치료; 뇌 성상세포종
- Citation
- Radiation oncology journal, v.27, no.1, pp.23 - 28
- Indexed
- KCI
- Journal Title
- Radiation oncology journal
- Volume
- 27
- Number
- 1
- Start Page
- 23
- End Page
- 28
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/177088
- DOI
- 10.3857/jkstro.2009.27.1.23
- ISSN
- 1229-8719
- Abstract
- PURPOSE:This study was designed to evaluate the effectiveness of postoperative radiotherapy for patients with low-grade astrocytomas and to define an optimal radiotherapeutic regimen and prognostic factors.
MATERIALS AND METHODS: A total of 69 patients with low-grade astrocytomas underwent surgery and postoperative radiotherapy immediately following surgery at our institution between October 1989 and September 2006. The median patient age was 36 years. Forty-one patients were 40 years or younger and 28 patients were 41 years or older. Fourteen patients underwent a biopsy alone and the remaining 55 patients underwent a subtotal resection. Thirty-nine patients had a Karnofsky performance status of less than 80% and 30 patients had a Karnofsky performance status greater than 80%. Two patients were treated with whole brain irradiation followed by a coned down boost field to the localized area. The remaining 67 patients were treated with a localized field with an appropriate margin. Most of the patients received a dose of 50~55 Gy and majority of the patients were treated with a dose of 54 Gy.
RESULTS: The overall 5-year and 7-year survival rates for all of the 69 patients were 49% and 44%, respectively. Corresponding disease free survival rates were 45% and 40%, respectively. Patients who underwent a subtotal resection showed better survival than patients who underwent a biopsy alone. The overall 5-year survival rates for patients who underwent a subtotal resection and patients who underwent a biopsy alone were 57% and 38%, respectively (p<0.05). Forty-one patients who were 40 years or younger showed a better overall 5-year survival rate as compared with 28 patients who were 41 years or older (56% versus 40%, p<0.05). The overall 5-year survival rates for 30 patients with a Karnofsky performance status greater than 80% and 39 patients with a Karnofsky performance status less than 80% were 51% and 47%, respectively. This finding was not statistically significant. Although one patient was not able to complete the treatment because of neurological deterioration, there were no significant treatment related toxicities.
CONCLUSION: Postoperative radiotherapy following surgery is a safe and effective treatment for patients with low-grade astrocytomas. The extent of surgery and age were noted as significant prognostic factors in this study. However, further effective treatment might be necessary in the future to improve long-term survival rates.
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