Oncotarget

Clinical Research Papers:

Comparison of chemoradiotherapy with radiotherapy alone for “biopsy only” anaplastic astrocytoma

Jing Wu, Ting Zou, Harrison Xiao Bai, Xuejun Li, Zishu Zhang, Bo Xiao, MacLean Nasrallah, Giorgos Karakousis, Ya Cao, Paul J. Zhang and Li Yang _

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Oncotarget. 2017; 8:69038-69046. https://doi.org/10.18632/oncotarget.17441

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Abstract

Jing Wu1,3,*, Ting Zou1,*, Harrison Xiao Bai2, Xuejun Li5, Zishu Zhang6, Bo Xiao3, MacLean Nasrallah4, Giorgos Karakousis7, Ya Cao8, Paul J. Zhang4 and Li Yang1

1 Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China

2 Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America

3 Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China

4 Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America

5 Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China

6 Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China

7 Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America

8 Cancer Research Institute, School of Basic Medicine, Central South University, Changsha, Hunan, China

* These authors have contributed equally to this study

Correspondence to:

Li Yang, email:

Keywords: chemoradiotherapy, anaplastic astrocytoma, National Cancer Database, radiotherapy, survival

Abbreviations: RT, Radiotherapy; CRT, Chemoradiotherapy; OS, Overall Survival; AA, Anaplastic Astrocytoma.

Received: December 16, 2016 Accepted: March 17, 2017 Published: April 26, 2017

Abstract

Background: It has become increasingly common to incorporate adjuvant chemotherapy with radiotherapy in the treatment of resected anaplastic astrocytoma based on results from recent phase II/III randomized trials. However, whether or not combined chemoradiotherapy is associated with improved survival outcome in patients who undergo “biopsy only” is less clear.

Methods: The US National Cancer Database was used to identify patients with histologically confirmed, biopsy-only anaplastic astrocytoma who received either radiotherapy alone or combined chemoradiotherapy from 2006 through 2014.

Results: In total, 1896 patients with biopsy-only anaplastic astrocytoma were included, among whom 363 (19.1%) received radiotherapy alone and 1533 (80.9%) received combined chemoradiotherapy. The median age at diagnosis was 60 years. Combined chemoradiotherapy was associated with a significant survival benefit when compared with radiotherapy alone on univariable analysis (median, 13.2 versus 5.6 months; hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.50-0.65; p < 0.001) and on multivariable analysis (HR, 0.62; 95% CI, 0.55-0.71; p < 0.001). A significant survival benefit for combined chemoradiotherapy persisted in a propensity score-matched analysis (HR, 0.67; 95% CI, 0.56-0.78; p<0.001).

Conclusions: Our results suggest that combined chemoradiotherapy may be associated with significantly improved survival over radiotherapy alone in patients with anaplastic astrocytoma who undergo biopsy only.


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