4 Validation and predictive power of radiation therapy oncology group (RTOG) recursive partitioning analysis classes for malignant glioma patients: A report using RTOG 90-06

Scott, Charles; Scarantino, Charles W.; Urtasun, Raul C.; Movsas, Benjamin; Jones, Christopher U.; Simpson, Joseph R.; Fischbach, A.Jennifer

doi:10.1016/s0360-3016(97)85345-x

Cited by 78 publications

(98 citation statements)

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“…This has been done successfully in patients with high-grade gliomas using recursive partitioning analysis. 28,29 Recursive partitioning analysis also has been performed in 401 patients with low-grade gliomas, 30 however, to our knowledge, the results have yet to be validated. The results of our study do not clarify the matter of the efficiency of tumor resection but point to the fact that it is possible to make functional strata using the HS/ MCU variable.…”

Section: Discussionmentioning

confidence: 99%

Positron emission tomography11C-methionine and survival in patients with low-grade gliomas

Ribom

Eriksson

Hartman

et al. 2001

Cancer

153

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Section: Discussionmentioning

confidence: 99%

Positron emission tomography11C-methionine and survival in patients with low-grade gliomas

Ribom

Eriksson

Hartman

et al. 2001

Cancer

153

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“…The reproducibility of this RPA classification system has been verified using cases from the later RTOG trial. 36 Li et al combined Classes V and VI of the original RPA classification because the survivals in these classes were not statistically different. This modified model was easier to apply because it involves only 4 variables: age, KPS, extent of resection, and neurological status.…”

Section: Other Srs Studies For Patients With Glioblastomamentioning

confidence: 99%

Role of adjuvant or salvage radiosurgery in the management of unresected residual or progressive glioblastoma multiforme in the pre–bevacizumab era

Niranjan

Kano

Iyer

et al. 2015

JNS

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abbreviatioNs ARE = adverse radiation effect; GBM = glioblastoma multiforme; KPS = Karnofsky Performance Scale; MST = median survival time; OS = overall survival; PFS = progression-free survival; RPA = recursive partitioning analysis; RT = radiation therapy; RTOG = Radiation Therapy Oncology Group; SRS = stereotactic radiosurgery. obJect After initial standard of care management of glioblastoma multiforme (GBM), relatively few proven options remain for patients with unresected progressive tumor. Numerous reports describe the value of radiosurgery, yet this modality appears to remain underutilized. The authors analyzed the outcomes of early adjuvant stereotactic radiosurgery (SRS) for unresected tumor or later salvage SRS for progressive GBM. Radiosurgery was performed as part of the multimodality management and was combined with other therapies. Patients continued to receive additional chemotherapy after SRS and prior to progression being documented. In this retrospective analysis, the authors evaluated factors that affected patient overall survival (OS) and progression-free survival. methods Between 1987 and 2008 the authors performed Gamma Knife SRS in 297 patients with histologically proven GBMs. All patients had received prior fractionated radiation therapy, and 66% had undergone one or more chemotherapy regimens. Ninety-six patients with deep-seated unresectable GBMs underwent biopsy only. Of those in whom excision had been possible, resection was considered to be gross total in 68 and subtotal in 133. The median patient age was 58 years (range 23-89 years) and the median tumor volume was 14 cm 3 (range 0.26-84.2 cm 3 ). The median prescription dose delivered to the imaging-defined tumor margin was 15 Gy (range 9-25 Gy). The median follow-up duration was 8.6 months (range 1.1-173 months). Cox regression models were used to analyze survival outcomes. Variables examined included age, residual versus recurrent tumor, prior chemotherapy, time to first recurrence, SRS dose, and gross tumor volume. results The median survival times after radiosurgery and after diagnosis were 9.03 and 18.1 months, respectively. The 1-year and 2-year OS after SRS were 37.9% and 16.7%, respectively. The 1-year and 2-year OS after diagnosis were 76.2% and 30.8%, respectively. Using multivariate analysis, factors associated with improved OS after diagnosis were younger age (< 60 years) at diagnosis (p < 0.0001), tumor volume < 14 cm 3 (p < 0.001), use of prior chemotherapy (p = 0.001), and radiosurgery at the time of recurrence (p < 0.0001). Multivariate analysis showed that younger age (p < 0.0001) and smaller tumor volume (< 14 cm 3 ) (p = 0.001) were significantly associated with increased OS after SRS. Adverse radiation effects were seen in 69 patients (23%). Fifty-eight patients (19.5%) underwent additional resection after SRS. The median survivals after diagnosis for recursive partitioning analysis Classes III, IV and V+VI were 31.6, 20.8, and 16.7 months, respectively. coNclusioNs In this analysis 30% of a heterogeneous cohort ...

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“…Even in case of maximal therapy, median survival of glioblastoma patients remains low and ranges between 10 and 12 months, only (Scott et al, 1998). Thus, a more profound knowledge of the molecular background and cell biological behaviour of this cancer is inevitable to develop appropriate treatment strategies (Buckner, 2003).…”

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confidence: 99%

Dynamics of chemosensitivity and chromosomal instability in recurrent glioblastoma

et al. 2007

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Glioblastoma multiforme is characterised by invasive growth and frequent recurrence. Here, we have analysed chromosomal changes in comparison to tumour cell aggressiveness and chemosensitivity of three cell lines established from a primary tumour and consecutive recurrences (BTL1 to BTL3) of a long-term surviving glioblastoma patient together with paraffin-embedded materials of five further cases with recurrent disease. Following surgery, the BTL patient progressed under irradiation/ lomustine but responded to temozolomide after re-operation to temozolomide. The primary tumour -derived BTL1 cells showed chromosomal imbalances typical of highly aggressive glioblastomas. Interestingly, BTL2 cells established from the first recurrence developed under therapy showed signs of enhanced chromosomal instability. In contrast, BTL3 cells from the second recurrence resembled a less aggressive subclone of the primary tumour. Although BTL2 cells exhibited a highly aggressive phenotype, BTL3 cells were characterised by reduced proliferative and migratory potential. Despite persistent methylation of the O 6 -methylguanine-DNA methyltransferase promoter, BTL3 cells exhibited the highest temozolomide sensitivity. A comparable situation was found in two out of five glioblastoma patients, both characterised by enhanced survival time, who also relapsed after surgery/chemotherapy with less aggressive recurrences. Taken together, our data suggest that pretreated glioblastoma patients may relapse with highly chemosensitive tumours confirming the feasibility of temozolomide treatment even in case of repeated recurrence.

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4 Validation and predictive power of radiation therapy oncology group (RTOG) recursive partitioning analysis classes for malignant glioma patients: A report using RTOG 90-06

Cited by 78 publications

References 0 publications

Positron emission tomography11C-methionine and survival in patients with low-grade gliomas

Positron emission tomography11C-methionine and survival in patients with low-grade gliomas

Role of adjuvant or salvage radiosurgery in the management of unresected residual or progressive glioblastoma multiforme in the pre–bevacizumab era

Dynamics of chemosensitivity and chromosomal instability in recurrent glioblastoma

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