Influence of an oligodendroglial component on the survival of patients with anaplastic astrocytomas: A report of Radiation Therapy Oncology Group 83-02

Bernadine Donahue, Charles B. Scott, James S. Nelson, Marvin Rotman, Kevin J. Murray, Diana F. Nelson, Franklin L. Banker, John D. Earle, Jennifer A. Fischbach, Sucha O. Asbell, Laurie E. Gaspar, Arnold Markoe, Walter Curran

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Abstract

Purpose: Seven percent of patients with high grade gliomas enrolled in RTOG 83-02 had mixed astrocytoma/oligodenroglial elements on central pathology review. It has often been assumed that the most aggressive histologic component of a tumor determines biologic behavior; however in this trial, the survival of patients who had mixed glioblastomas/oligodenrogliomas was significantly longer than that of patients with pure glioblastomas (GBM). We therefore evaluated the effect of an oligodendroglial component on the survival of patients who had anaplastic astrocytomas (AAF) treated in the same trial. Methods and Materials: One hundred nine patients who had AAF and 24 patients with mixed AAF/oligodendrogliomas (AAF/OL) were enrolled in a Phase I/II trial of randomized dose-escalation hyperfractioned radiotherapy plus BCNU. AAF/OL patients were older and more likely to have had more aggressive surgery than AAF patients. Other pretreatment characteristics were balanced between groups, as was assigned treatment. Results: The median survival time for AAF was 3.0 years versus 7.3 years for AAF/OL (p = 0.019). In a multivariate analysis, adjusting for extent of surgical resection and age, an oligodendroglial component was an independent prognostic factor for survival. Conclusion: The results support the concept that AAFs with an oligodendroglial component have a better prognosis than pure AAF tumors, similar to the effect seen among patients with glioblastoma multiforme tumors. This better survival outcome should be taken into consideration in the design and stratification of future trials. Additionally, in contrast to patients with GBMs, patients who have AAF/OL have the potential for prolonged survival; therefore, late sequelae of treatment (both radiation and chemotherapy) must be weighed more heavily in the benefits to risks analysis.

Original languageEnglish
Pages (from-to)911-914
Number of pages4
JournalInternational Journal of Radiation Oncology Biology Physics
Volume38
Issue number5
DOIs
StatePublished - Jul 15 1997

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Radiation Oncology
Astrocytoma
radiation therapy
Radiotherapy
Survival
Oligodendroglioma
Glioblastoma
tumors
Carmustine
Neoplasms
prognosis
pathology
chemotherapy
stratification
surgery
Glioma
pretreatment
grade
Multivariate Analysis
adjusting

Keywords

  • Anaplastic astrocytoma
  • Hyperfractionation
  • Oligodendroglioma

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Influence of an oligodendroglial component on the survival of patients with anaplastic astrocytomas : A report of Radiation Therapy Oncology Group 83-02. / Donahue, Bernadine; Scott, Charles B.; Nelson, James S.; Rotman, Marvin; Murray, Kevin J.; Nelson, Diana F.; Banker, Franklin L.; Earle, John D.; Fischbach, Jennifer A.; Asbell, Sucha O.; Gaspar, Laurie E.; Markoe, Arnold; Curran, Walter.

In: International Journal of Radiation Oncology Biology Physics, Vol. 38, No. 5, 15.07.1997, p. 911-914.

Research output: Contribution to journalArticle

Donahue, B, Scott, CB, Nelson, JS, Rotman, M, Murray, KJ, Nelson, DF, Banker, FL, Earle, JD, Fischbach, JA, Asbell, SO, Gaspar, LE, Markoe, A & Curran, W 1997, 'Influence of an oligodendroglial component on the survival of patients with anaplastic astrocytomas: A report of Radiation Therapy Oncology Group 83-02', International Journal of Radiation Oncology Biology Physics, vol. 38, no. 5, pp. 911-914. https://doi.org/10.1016/S0360-3016(97)00126-0
Donahue, Bernadine ; Scott, Charles B. ; Nelson, James S. ; Rotman, Marvin ; Murray, Kevin J. ; Nelson, Diana F. ; Banker, Franklin L. ; Earle, John D. ; Fischbach, Jennifer A. ; Asbell, Sucha O. ; Gaspar, Laurie E. ; Markoe, Arnold ; Curran, Walter. / Influence of an oligodendroglial component on the survival of patients with anaplastic astrocytomas : A report of Radiation Therapy Oncology Group 83-02. In: International Journal of Radiation Oncology Biology Physics. 1997 ; Vol. 38, No. 5. pp. 911-914.
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abstract = "Purpose: Seven percent of patients with high grade gliomas enrolled in RTOG 83-02 had mixed astrocytoma/oligodenroglial elements on central pathology review. It has often been assumed that the most aggressive histologic component of a tumor determines biologic behavior; however in this trial, the survival of patients who had mixed glioblastomas/oligodenrogliomas was significantly longer than that of patients with pure glioblastomas (GBM). We therefore evaluated the effect of an oligodendroglial component on the survival of patients who had anaplastic astrocytomas (AAF) treated in the same trial. Methods and Materials: One hundred nine patients who had AAF and 24 patients with mixed AAF/oligodendrogliomas (AAF/OL) were enrolled in a Phase I/II trial of randomized dose-escalation hyperfractioned radiotherapy plus BCNU. AAF/OL patients were older and more likely to have had more aggressive surgery than AAF patients. Other pretreatment characteristics were balanced between groups, as was assigned treatment. Results: The median survival time for AAF was 3.0 years versus 7.3 years for AAF/OL (p = 0.019). In a multivariate analysis, adjusting for extent of surgical resection and age, an oligodendroglial component was an independent prognostic factor for survival. Conclusion: The results support the concept that AAFs with an oligodendroglial component have a better prognosis than pure AAF tumors, similar to the effect seen among patients with glioblastoma multiforme tumors. This better survival outcome should be taken into consideration in the design and stratification of future trials. Additionally, in contrast to patients with GBMs, patients who have AAF/OL have the potential for prolonged survival; therefore, late sequelae of treatment (both radiation and chemotherapy) must be weighed more heavily in the benefits to risks analysis.",
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