Early Toxicity and Long-Term Survival in High-Grade Glioma
Author Information
Author(s): Lawrence Y R, Wang M, Dicker A P, Andrews D, Curran W J Jr, Michalski J M, Souhami L, Yung W-Ka, Mehta M
Primary Institution: Thomas Jefferson University, Kimmel Cancer Center
Hypothesis
What is the incidence of acute and late neurological toxicity following radiation therapy for high-grade glioma?
Conclusion
Acute neurological toxicity is significantly associated with both late neurological toxicity and poorer overall survival.
Supporting Evidence
- Patients with acute neurological toxicity had a median survival of 7.8 months compared to 11.8 months for those without.
- Acute neurological toxicity occurred in 182 out of 2610 patients (7.0%).
- Late neurological toxicity was reported in 83 patients (3.5%).
- Older age, poor performance status, and aggressive surgery were associated with increased acute neurological toxicity.
Takeaway
If patients with high-grade glioma have bad side effects early on from treatment, they might not live as long. It's important to watch for these side effects.
Methodology
The study analyzed acute and late neurological toxicities among 2761 patients from 14 RTOG trials using logistic regression models.
Potential Biases
There is a risk of misclassification bias in attributing neurological symptoms to treatment versus tumor progression.
Limitations
The study is retrospective and may have misclassification bias regarding neurological events.
Participant Demographics
The study included 2610 patients, predominantly with glioblastoma (86%) and anaplastic astrocytoma (10%).
Statistical Information
P-Value
0.014
Confidence Interval
95% CI=1.2–4.8
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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