Survival after stereotactic biopsy and irradiation of cerebral nonanaplastic, nonpilocytic astrocytoma
- 1 April 1995
- journal article
- clinical trial
- Published by Journal of Neurosurgery Publishing Group (JNSPG) in Journal of Neurosurgery
- Vol. 82 (4), 523-529
- https://doi.org/10.3171/jns.1995.82.4.0523
Abstract
The authors investigated the outcome of stereotactic biopsy and radiotherapy in 35 consecutive adult patients with nonanaplastic, nonpilocytic astrocytomas who were diagnosed between 1982 and 1992. The median patient age at presentation was 32 years. All received fractionated external-beam radiation therapy (median dose 56 Gy) as the initial management strategy. Additional treatment in two patients included intracavitary irradiation with colloidal phosphorus-32. Six patients (17%) had documented tumor progression during the follow-up interval and died. Three others died of causes unrelated to their tumor. Median survival after stereotactic biopsy and irradiation was 118 months (9.8 years). Median survival from the time of onset of neurological symptoms was 148 months (12.3 years). Only three patients required delayed cytoreductive surgery. The outcome of brain astrocytomas, although improved because of earlier diagnosis and therapy, does not substantiate this tumor as having benign behavior; early recognition with neuroimaging, immediate histological diagnosis via stereotactic biopsy, and initial fractionated radiation therapy may provide the potential for longer survival for patients with low-grade astrocytomas. The majority of such surviving patients have a satisfactory quality of life, which is manifested by prolonged normal functional and employment status. The survival data reported in this prospective Phase I-II clinical trial suggest that stereotactic biopsy and radiation therapy are appropriate initial management strategies for astrocytomas.Keywords
This publication has 28 references indexed in Scilit:
- Unreliability of contemporary neurodiagnostic imaging in evaluating suspected adult supratentorial (low-grade) astrocytomaJournal of Neurosurgery, 1993
- Morbidity and mortality of craniotomy for excision of supratentorial gliomasNeurology, 1988
- Cerebral hemisphere astrocytoma: Treatment resultsRadiotherapy and Oncology, 1987
- Glioblastoma multiforme and anaplastic astrocytoma pathologic criteria and prognostic implicationsCancer, 1985
- Histologic and non-histologic factors correlated with survival time in supratentorial astrocytic tumorsJournal of Neuro-Oncology, 1985
- The value of radiation therapy in addition to surgery for astrocytomas of the adult cerebrumCancer, 1985
- Intracranial tumors: response and resistance to therapeutic endeavors, 1970–1980International Journal of Radiation Oncology*Biology*Physics, 1982
- Treatment of grades I and II brain astrocytomas. the role of radiotherapyInternational Journal of Radiation Oncology*Biology*Physics, 1977
- The Relatively Benign Astrocytomas of the CerebrumJournal of Neurosurgery, 1961
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958