Comparison of Treatment Results of Malignant Astrocytoma after post-op Radiotherapy Alone or post-op Concurrent Chemoradiotherapy plus Adjuvant chemotherapy-Experience in TSGH

貢獻的翻譯標題: 惡性星狀細胞瘤術後放療或合併放化療治療結果之比較:三軍總醫院的經驗

Kuen-Tze Lin, Ching-Jung Wu, Yee-Min Jen, Meei Shyuan Lee, Wen-Yen Huang, Chang-Ming Chen, Hsing-Lung Chao, Chun-Shu Lin, Yu-Fu Su, Jang-Chun Lin

研究成果: 雜誌貢獻文章

摘要

目的:分析惡性星狀細胞瘤術後放療或合併放化療治療結果及預後因子。
材料及方法:從2002年4月至2007年12月,共有35位新診斷惡性星狀細胞瘤及多形惡性神經膠質瘤的病人接受手術切除,術後接受放射治療或同步放化療。放射治療使用三度空間順形放射治療(3DCRT),於六週內給予60 Gy。我們使用影像結合的技術,結合術前核磁共振及電腦斷層定位的影像,決定治療區域的範圍。化學治療使用帝盟多,在同步放化療的過程,劑量為每天75 mg/平方公尺,至少使用49天。放療後化療,28天為一個療程,每個療程前5天接受化療,劑量為每天150-200 mg/平方公尺,至少6個療程。追蹤和存活時間的定義為切片診斷的日期到碼死亡的日期。存活率曲線以Kaplan-Meier方法繪製。
結果:平均追蹤時間為19.1個月。追蹤期間內,共10位病人存活,25位病人死亡。所有病人的平均存活率為19.1個月。三年存活率,在放療這組為14%,放化療這組為43%(p值=0.002)。三年無復發存活率,在放療這組為10.6%,放化療這組為13.9%(p值=0.54)。惡性
星狀細胞瘤的病人,存活率在放療這組為8.7%,放化療這組為67.9%(p值=0.001)。多形惡性神經膠質瘤的病人,存活率在放療這組為16.3%,放化療這組為23.7%(p值=0.261)。放射治療照野內的復發為主要的復發型態。所有35位病人中,有22位病人發生照野內復發(62.8%)。所有的病人皆完成放射治療。30位病人(86%)產生GradeI中樞神經毒性;5位病人(14%)產生Grade Ⅱ中樞神經毒性。21位接受化療的病人中,18位病人在化療過程中並沒有任何副作用產生。
結論:對於新診斷的惡性星狀細胞瘤及多形惡性神經膠質瘤的病人手術切除後,術後接受同步放化療有統計學上存活率的幫助而僅有可接受之副作用。
原文英語
頁(從 - 到)37-45
頁數9
期刊放射治療與腫瘤學
18
發行號1
DOIs
出版狀態已發佈 - 三月 1 2011
對外發佈Yes

指紋

Astrocytoma
Chemoradiotherapy
Adjuvant Chemotherapy
Radiotherapy
temozolomide
Survival Rate
Therapeutics
Glioblastoma
Disease-Free Survival
Survival

Keywords

  • 惡性星狀細胞瘤
  • 多形惡性神經膠質瘤
  • 帝盟多
  • 放射治療
  • 同步放射化學治療
  • 順形放射治療

引用此文

Comparison of Treatment Results of Malignant Astrocytoma after post-op Radiotherapy Alone or post-op Concurrent Chemoradiotherapy plus Adjuvant chemotherapy-Experience in TSGH. / Lin, Kuen-Tze; Wu, Ching-Jung; Jen, Yee-Min; Lee, Meei Shyuan; Huang, Wen-Yen; Chen, Chang-Ming; Chao, Hsing-Lung; Lin, Chun-Shu; Su, Yu-Fu; Lin, Jang-Chun.

於: 放射治療與腫瘤學, 卷 18, 編號 1, 01.03.2011, p. 37-45.

研究成果: 雜誌貢獻文章

Lin, Kuen-Tze ; Wu, Ching-Jung ; Jen, Yee-Min ; Lee, Meei Shyuan ; Huang, Wen-Yen ; Chen, Chang-Ming ; Chao, Hsing-Lung ; Lin, Chun-Shu ; Su, Yu-Fu ; Lin, Jang-Chun. / Comparison of Treatment Results of Malignant Astrocytoma after post-op Radiotherapy Alone or post-op Concurrent Chemoradiotherapy plus Adjuvant chemotherapy-Experience in TSGH. 於: 放射治療與腫瘤學. 2011 ; 卷 18, 編號 1. 頁 37-45.
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title = "Comparison of Treatment Results of Malignant Astrocytoma after post-op Radiotherapy Alone or post-op Concurrent Chemoradiotherapy plus Adjuvant chemotherapy-Experience in TSGH",
abstract = "Purpose: To analyze the treatment results of malignant astrocytoma after radiotherapy alone or concurrent chemoradiotherapy plus adjuvant chemotherapy in TSGH.Methods and Materials: From April 2002 to December 2007, we identified 35 patients with documented, histologically confirmed, previously untreated glioblastoma multiforme (GBM) or anaplastic astrocytoma (AA). They were treated with surgical resection followed by radiotherapy alone or chemoradiotherapy in our hospital. A total of 60 Gy was given in 6 weeks with 3D conformal RT (3D-CRT). Fusion of planning CT with MRI was routinely used to assist target delineation. We used concomitant temozolomide (75 mg/m^2 daily up to 49 days) followed by up to six cycles of adjuvant temozolomide (150 to 200 mg/m^2 daily for five days, every 28 days). Follow-up and survival times were calculated from the date of diagnosis to the date of last contact or death. Disease-free survival (DFS) and overall survival (OS) were computed by Kaplan-Meier methods.Results: The median follow-up was 19.1 months. At the time of analysis, 10 patients were alive, 25 patients had died. The median survival rate was 19.1 months for all patients. The 3-year overall survival rates were 14{\%} and 43{\%} in radiotherapy alone arm and CCRT arm, respectively. (p=0.002). The 3-year progression-free survival rates were 10.6{\%} and 13.9{\%} in radiotherapy alone and CCRT arm, respectively. (p=0.54). In the AA group, the overall survival rates were 8.7{\%} and 67.9{\%} in radiotherapy alone arm and CCRT arm, respectively. (p=0.001). In the GBM group, the overall survival rates were 16.3{\%} and 23.7{\%} in radiotherapy alone and CCRT arm, respectively. (p=0.261). In-field failure was the major cause of failure, among 35 patients, 22 (62.8{\%}) patients had in-field failure. All patients completed radiotherapy courses. Thirty (86{\%}) patients had grade 1 CNS toxicity and 5 (14{\%}) patients had grade 2 CNS toxicity. Among 21 patients who received temozolomide, 18 patients had no obvious side effects during and after chemotherapy.Conclusions: Addition of adjuvant chemotherapy with temozolomide to radiotherapy for patients with newly diagnosed AA and GBM has statistically significant survival benefit especially for patients of AA with tolerable toxicity.",
keywords = "Anaplastic astrocytoma, Glioblastoma multiforme, Temozolomide, Radiotherapy, Chemoradiotherapy, Conformal radiation therapy, 惡性星狀細胞瘤, 多形惡性神經膠質瘤, 帝盟多, 放射治療, 同步放射化學治療, 順形放射治療",
author = "Kuen-Tze Lin and Ching-Jung Wu and Yee-Min Jen and Lee, {Meei Shyuan} and Wen-Yen Huang and Chang-Ming Chen and Hsing-Lung Chao and Chun-Shu Lin and Yu-Fu Su and Jang-Chun Lin",
year = "2011",
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language = "English",
volume = "18",
pages = "37--45",
journal = "放射治療與腫瘤學",
issn = "1023-988x",
publisher = "台灣放射腫瘤學會",
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TY - JOUR

T1 - Comparison of Treatment Results of Malignant Astrocytoma after post-op Radiotherapy Alone or post-op Concurrent Chemoradiotherapy plus Adjuvant chemotherapy-Experience in TSGH

AU - Lin, Kuen-Tze

AU - Wu, Ching-Jung

AU - Jen, Yee-Min

AU - Lee, Meei Shyuan

AU - Huang, Wen-Yen

AU - Chen, Chang-Ming

AU - Chao, Hsing-Lung

AU - Lin, Chun-Shu

AU - Su, Yu-Fu

AU - Lin, Jang-Chun

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Purpose: To analyze the treatment results of malignant astrocytoma after radiotherapy alone or concurrent chemoradiotherapy plus adjuvant chemotherapy in TSGH.Methods and Materials: From April 2002 to December 2007, we identified 35 patients with documented, histologically confirmed, previously untreated glioblastoma multiforme (GBM) or anaplastic astrocytoma (AA). They were treated with surgical resection followed by radiotherapy alone or chemoradiotherapy in our hospital. A total of 60 Gy was given in 6 weeks with 3D conformal RT (3D-CRT). Fusion of planning CT with MRI was routinely used to assist target delineation. We used concomitant temozolomide (75 mg/m^2 daily up to 49 days) followed by up to six cycles of adjuvant temozolomide (150 to 200 mg/m^2 daily for five days, every 28 days). Follow-up and survival times were calculated from the date of diagnosis to the date of last contact or death. Disease-free survival (DFS) and overall survival (OS) were computed by Kaplan-Meier methods.Results: The median follow-up was 19.1 months. At the time of analysis, 10 patients were alive, 25 patients had died. The median survival rate was 19.1 months for all patients. The 3-year overall survival rates were 14% and 43% in radiotherapy alone arm and CCRT arm, respectively. (p=0.002). The 3-year progression-free survival rates were 10.6% and 13.9% in radiotherapy alone and CCRT arm, respectively. (p=0.54). In the AA group, the overall survival rates were 8.7% and 67.9% in radiotherapy alone arm and CCRT arm, respectively. (p=0.001). In the GBM group, the overall survival rates were 16.3% and 23.7% in radiotherapy alone and CCRT arm, respectively. (p=0.261). In-field failure was the major cause of failure, among 35 patients, 22 (62.8%) patients had in-field failure. All patients completed radiotherapy courses. Thirty (86%) patients had grade 1 CNS toxicity and 5 (14%) patients had grade 2 CNS toxicity. Among 21 patients who received temozolomide, 18 patients had no obvious side effects during and after chemotherapy.Conclusions: Addition of adjuvant chemotherapy with temozolomide to radiotherapy for patients with newly diagnosed AA and GBM has statistically significant survival benefit especially for patients of AA with tolerable toxicity.

AB - Purpose: To analyze the treatment results of malignant astrocytoma after radiotherapy alone or concurrent chemoradiotherapy plus adjuvant chemotherapy in TSGH.Methods and Materials: From April 2002 to December 2007, we identified 35 patients with documented, histologically confirmed, previously untreated glioblastoma multiforme (GBM) or anaplastic astrocytoma (AA). They were treated with surgical resection followed by radiotherapy alone or chemoradiotherapy in our hospital. A total of 60 Gy was given in 6 weeks with 3D conformal RT (3D-CRT). Fusion of planning CT with MRI was routinely used to assist target delineation. We used concomitant temozolomide (75 mg/m^2 daily up to 49 days) followed by up to six cycles of adjuvant temozolomide (150 to 200 mg/m^2 daily for five days, every 28 days). Follow-up and survival times were calculated from the date of diagnosis to the date of last contact or death. Disease-free survival (DFS) and overall survival (OS) were computed by Kaplan-Meier methods.Results: The median follow-up was 19.1 months. At the time of analysis, 10 patients were alive, 25 patients had died. The median survival rate was 19.1 months for all patients. The 3-year overall survival rates were 14% and 43% in radiotherapy alone arm and CCRT arm, respectively. (p=0.002). The 3-year progression-free survival rates were 10.6% and 13.9% in radiotherapy alone and CCRT arm, respectively. (p=0.54). In the AA group, the overall survival rates were 8.7% and 67.9% in radiotherapy alone arm and CCRT arm, respectively. (p=0.001). In the GBM group, the overall survival rates were 16.3% and 23.7% in radiotherapy alone and CCRT arm, respectively. (p=0.261). In-field failure was the major cause of failure, among 35 patients, 22 (62.8%) patients had in-field failure. All patients completed radiotherapy courses. Thirty (86%) patients had grade 1 CNS toxicity and 5 (14%) patients had grade 2 CNS toxicity. Among 21 patients who received temozolomide, 18 patients had no obvious side effects during and after chemotherapy.Conclusions: Addition of adjuvant chemotherapy with temozolomide to radiotherapy for patients with newly diagnosed AA and GBM has statistically significant survival benefit especially for patients of AA with tolerable toxicity.

KW - Anaplastic astrocytoma

KW - Glioblastoma multiforme

KW - Temozolomide

KW - Radiotherapy

KW - Chemoradiotherapy

KW - Conformal radiation therapy

KW - 惡性星狀細胞瘤

KW - 多形惡性神經膠質瘤

KW - 帝盟多

KW - 放射治療

KW - 同步放射化學治療

KW - 順形放射治療

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DO - http://www.airitilibrary.com/Publication/alDetailedMesh?docid=1023988x-201103-201104160006-201104160006-37-45

M3 - Article

VL - 18

SP - 37

EP - 45

JO - 放射治療與腫瘤學

JF - 放射治療與腫瘤學

SN - 1023-988x

IS - 1

ER -