Trends in radiation dose for low grade gliomas across the United States

Byrne, Emma; Abel, Stephen; Yu, Alexander; Shepard, Matthew J.; Karlovits, Stephen; Wegner, Rodney E.

doi:10.1007/s11060-022-03962-4

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…Given that this change became official in relatively recent times, it is not surprising that pivotal prospective trials that guide current clinical decisions were based on the histological diagnosis of oligodendroglioma (7,8). Retrospective research conducted before or even after that critical change studied a mix of histological and molecularly diagnosed oligodendrogliomas with the risk of including tumors that may not be classified as oligodendrogliomas now (9)(10)(11)(12)(13)(14)(15). There is a paucity of studies on purely molecularly defined oligodendrogliomas and those usually have a small number of patients or limited follow-up time (16)(17)(18)(19)(20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Current and Future Frontiers of Molecularly Defined Oligodendrogliomas

et al. 2022

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Oligodendrogliomas are a subtype of adult diffuse glioma characterized by their better responsiveness to systemic chemotherapy than other high-grade glial tumors. The World Health Organization (WHO) 2021 brain tumor classification highlighted defining molecular markers, including 1p19q codeletion and IDH mutations which have become key in diagnosing and treating oligodendrogliomas. The management for patients with oligodendrogliomas includes observation or surgical resection potentially followed by radiation and chemotherapy with PCV (Procarbazine, Lomustine, and Vincristine) or Temozolomide. However, most of the available research about oligodendrogliomas includes a mix of histologically and molecularly diagnosed tumors. Even data driving our current management guidelines are based on post-hoc subgroup analyses of the 1p19q codeleted population in landmark prospective trials. Therefore, the optimal treatment paradigm for molecularly defined oligodendrogliomas is incompletely understood. Many questions remain open, such as the optimal timing of radiation and chemotherapy, the response to different chemotherapeutic agents, or what genetic factors influence responsiveness to these agents. Ultimately, oligodendrogliomas are still incurable and new therapies, such as targeting IDH mutations, are necessary. In this opinion piece, we present relevant literature in the field, discuss current challenges, and propose some studies that we think are necessary to answer these critical questions.

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Section: Introductionmentioning

confidence: 99%

Current and Future Frontiers of Molecularly Defined Oligodendrogliomas

et al. 2022

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The impact of adjuvant radiotherapy on overall survival in spinal low-grade gliomas: a propensity score-matched analysis

El-Hajj,

Ranganathan,

Hoang

et al. 2024

J Neurooncol

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Introduction Spinal low-grade gliomas (sLGGs) are a group of tumors that arise from glial cells in the spinal cord. Current evidence supporting the use of adjuvant radiotherapy for the management of sLGG is lacking. We hence aimed to compare overall survival rates in patients receiving surgery alone with those receiving surgery with adjuvant radiotherapy. Methods The NCDB, a large, nationwide, US-based cancer registry was used. Relevant cases were identified using the following ICD-O-3 histological codes: 9382, 9384, 9400, 9410, 9411, 9420, 9421, 9424, 9425, and 9450, along with the ICD-O-3 topographical codes for spinal meninges (C70.1) and spinal cord (C72.0), excluding spinal ependymomas. Overall survival was the primary outcome. Propensity score matching 1:1 was used to balance the cohorts prior to Kaplan-Meier survival analysis. Results A total of 552 patients were included in the study, with 440 in the surgery alone group and 156 in the surgery with adjuvant radiotherapy group. Patients in the surgery with adjuvant radiotherapy group were significantly older (median age 40.0 vs. 24.0 years, p < 0.001), and exhibited higher proportions of WHO grade 2 tumors (p < 0.001). Adjuvant chemotherapy was more frequently administered in the surgery with adjuvant radiotherapy group (23% vs. 7%, p < 0.001). Overall, adjuvant radiotherapy was not associated with improved survival, with a significantly higher mortality in the radiotherapy group before propensity score matching (p < 0.0001). After matching, the difference in overall survival was no longer significant (p = 0.11). Conclusion This study found no significant overall survival benefit associated with the use of adjuvant radiotherapy for spinal low-grade gliomas (sLGG). Although patients who received adjuvant radiotherapy initially demonstrated higher mortality rates, this difference was largely due to confounding factors such as more advanced disease in this group.

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