The role of radiation therapy in the treatment of astrocytomas

Abstract

One hundred forty-seven patients with astrocytoma were treated between 1942 and 1967. There were 25 postoperative deaths. The 14 patients in whom the tumor was thought tohave been completely removed were not irradiated and all survived 5 years or longer. Seventy-one of the 108 patients with imcompletely excised lesions received radiation therapy. The 5-year survival rate for those with imcomplete resection alone was 19%, compared to 46% when irradiation was given. Based on observations up to 20 years, after incomplete removal postoperative irradiation significally prolonged useful life and may have lead to permanent control in some. There was no evidence of radiation damage. Most of these tumors were fibrillary astrocytomas, and the results apply particularly to this histologic type. Only 1 of 11 patients with gemistocytic astrocytoma survivied 5 years. The survival rate for Grade i tumors was appreciably greater than for Grade iilesions; in both grades, it was improved by irradiation.

Neurosurgical considerations in supratentorial low-grade gliomas: experience with 175 patients

“…Using the Kernohan system, Fazekas [22] reported a better survival rate in patients with Grade 1 astrocytomas as compared to those with Grade 2 astrocytomas. The same conclusion was reached by Philippon, et al, [63] and Leibel, et al, [43] who found a marked survival advantage in patients with Grade 1 over Grade 2 tumors, although those with Grade 2 might have included higher grades and Grade 1 may have included the pilocytic variety, which is found to behave extremely favorably. [25,47] On the contrary, Laws, et al, [42] and North, et al, [58] found that histological subtype had no influence on survival rates.…”

Combined intra-arterial chemotherapy followed by radiation in astrocytomas

“…Fazekas reported 5 and 10 year survivals of 54% and 26%, respectively, in a series of 45 patients irradiated postoperatively for astrocytomas and 32% survival at 5 and 10 years in 23 non-radiated cases [13]. Leibel reported 5 and 10 year survivals of 46% and 35% in 71 patients treated with incomplete surgical resection and postoperative radiation, and of 19% and 11% in a similar group of incompletely resected patients who did not receive post-operative radiation [7]. In our control study the median survival in patients > 40 years was 2 years with only 22% of the patients surviving at 5 years (Fig.…”

“…Controversy exists concerning how long a patient shall be routinely followed by imaging before an operative procedure is performed and the impact of the extent of surgery still has to be defined [6][7][8][9]. There is also no universal agreement as to the timing and efficacy of radiation therapy [3,10,11].…”

Spectral and lifetime domain measurements of rat brain tumors

“…Nowadays, for many cases surgery intervention remains a valuable treatment for high-grade glioblastoma [1]. Nevertheless, a major limitation of this technique lies in the delineation of tumor sites [2,3], which affects the patient's prognostic. Nowadays, survival periods after operation are in the range of 12-18 months only, numerous patients experiencing a relapse [4][5][6].…”