Comparing Two Radiotherapy Doses for Astrocytoma Treatment
Author Information
Author(s): N.M. Bleehen, S.P. Stenning
Primary Institution: Medical Research Council
Hypothesis
Does a higher dose of radiotherapy improve survival in patients with grades 3 and 4 astrocytoma?
Conclusion
A higher dose of 60 Gy results in a modest increase in median survival compared to 45 Gy.
Supporting Evidence
- Patients receiving 60 Gy had a median survival of 12 months compared to 9 months for those receiving 45 Gy.
- Over 80% of patients reported no morbidity from the radiotherapy.
- The study included 474 patients from 15 centers in the UK and one in South Africa.
- A prognostic index was validated, identifying a group of patients with a 2-year survival rate of 28%.
- Statistical analysis showed a significant improvement in survival with the higher dose.
- Survival rates at 12 months were 29% for 45 Gy and 39% for 60 Gy.
- The study aimed to provide 90% power to detect a 10% improvement in 18-month survival.
Takeaway
Patients with a brain tumor lived a little longer when they received a higher dose of radiation after surgery.
Methodology
Patients were randomized to receive either 45 Gy or 60 Gy of radiotherapy after surgery, and their survival was monitored.
Potential Biases
The study was stratified by participating center, but there may be biases in patient selection and treatment adherence.
Limitations
Late morbidity was not assessed, and the study did not include adjuvant chemotherapy.
Participant Demographics
Adult patients aged 18 to 70 with pathologically proven grade 3 or 4 astrocytoma.
Statistical Information
P-Value
0.007
Confidence Interval
95% CI 1 to 6 months
Statistical Significance
p=0.007
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