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Modulated Radiotherapy with Concurrent and Adjuvant Temozolomide for Anaplastic Gliomas: Indian Single-center Data

OBJECTIVE: To evaluate early clinical outcome for anaplastic gliomas (AG) treated in the era of modulated radiotherapy (RT) and concurrent plus adjuvant temozolomide (TMZ) in an Indian setting. MATERIALS AND METHODS: Fifty-three patients with AGs treated with modulated RT and concurrent (95%) and ad...

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Autores principales: Kataria, Tejinder, Basu, Trinanjan, Gupta, Deepak, Goyal, Shikha, Nasreen, Shahida, Bisht, Shyam S, Abhishek, Ashu, Banerjee, Susovan, Narang, Kushal, Jha, Ajaya N, Mohapatra, Ishani, Modi, Jayesh A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5759071/
https://www.ncbi.nlm.nih.gov/pubmed/29333019
http://dx.doi.org/10.4103/ijmpo.ijmpo_200_16
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author Kataria, Tejinder
Basu, Trinanjan
Gupta, Deepak
Goyal, Shikha
Nasreen, Shahida
Bisht, Shyam S
Abhishek, Ashu
Banerjee, Susovan
Narang, Kushal
Jha, Ajaya N
Mohapatra, Ishani
Modi, Jayesh A
author_facet Kataria, Tejinder
Basu, Trinanjan
Gupta, Deepak
Goyal, Shikha
Nasreen, Shahida
Bisht, Shyam S
Abhishek, Ashu
Banerjee, Susovan
Narang, Kushal
Jha, Ajaya N
Mohapatra, Ishani
Modi, Jayesh A
author_sort Kataria, Tejinder
collection PubMed
description OBJECTIVE: To evaluate early clinical outcome for anaplastic gliomas (AG) treated in the era of modulated radiotherapy (RT) and concurrent plus adjuvant temozolomide (TMZ) in an Indian setting. MATERIALS AND METHODS: Fifty-three patients with AGs treated with modulated RT and concurrent (95%) and adjuvant TMZ (90%) were analyzed. About 80% of patients had Karnofsky performance status (KPS) at least 90 with 30% seizure at presentation. Postoperative magnetic resonance imaging was available in 65% cases and RT dose was 60 Gy in 30 fractions. First posttreatment imaging was performed at 1 month and then at 3 and 6 months post-RT and then every 3 months. Kaplan–Meier analysis was used to estimate disease-free survival (DFS) and overall survival (OS), and analysis was done using SPSS version 18.0. RESULTS: With median follow-up of 25 months, 2-year DFS and OS were 75% and 88%. There were only 5% symptomatic central nerves system and 8% symptomatic hematological toxicities. At the 1(st) evaluation, 30.4% had complete response (CR), at 3 months 40%, and at 6 months 43%. At 6 months, only 4% had progressive disease. Forty-six patients were evaluable till the last follow-up with and 55% had stable to CR. On univariate analysis for DFS, KPS at presentation >90 (P = 0.001) and response at 6 months (P = 0.02) were significant and for OS KPS at presentation (P = 0.004) alone. CONCLUSION: Modulated RT with TMZ among Grade III glioma patients resulted in minimum treatment-related toxicities and encouraging survival. Molecular prognostic markers will determine most favorable groups in future.
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spelling pubmed-57590712018-01-12 Modulated Radiotherapy with Concurrent and Adjuvant Temozolomide for Anaplastic Gliomas: Indian Single-center Data Kataria, Tejinder Basu, Trinanjan Gupta, Deepak Goyal, Shikha Nasreen, Shahida Bisht, Shyam S Abhishek, Ashu Banerjee, Susovan Narang, Kushal Jha, Ajaya N Mohapatra, Ishani Modi, Jayesh A Indian J Med Paediatr Oncol Original Article OBJECTIVE: To evaluate early clinical outcome for anaplastic gliomas (AG) treated in the era of modulated radiotherapy (RT) and concurrent plus adjuvant temozolomide (TMZ) in an Indian setting. MATERIALS AND METHODS: Fifty-three patients with AGs treated with modulated RT and concurrent (95%) and adjuvant TMZ (90%) were analyzed. About 80% of patients had Karnofsky performance status (KPS) at least 90 with 30% seizure at presentation. Postoperative magnetic resonance imaging was available in 65% cases and RT dose was 60 Gy in 30 fractions. First posttreatment imaging was performed at 1 month and then at 3 and 6 months post-RT and then every 3 months. Kaplan–Meier analysis was used to estimate disease-free survival (DFS) and overall survival (OS), and analysis was done using SPSS version 18.0. RESULTS: With median follow-up of 25 months, 2-year DFS and OS were 75% and 88%. There were only 5% symptomatic central nerves system and 8% symptomatic hematological toxicities. At the 1(st) evaluation, 30.4% had complete response (CR), at 3 months 40%, and at 6 months 43%. At 6 months, only 4% had progressive disease. Forty-six patients were evaluable till the last follow-up with and 55% had stable to CR. On univariate analysis for DFS, KPS at presentation >90 (P = 0.001) and response at 6 months (P = 0.02) were significant and for OS KPS at presentation (P = 0.004) alone. CONCLUSION: Modulated RT with TMZ among Grade III glioma patients resulted in minimum treatment-related toxicities and encouraging survival. Molecular prognostic markers will determine most favorable groups in future. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5759071/ /pubmed/29333019 http://dx.doi.org/10.4103/ijmpo.ijmpo_200_16 Text en Copyright: © 2017 Indian Journal of Medical and Paediatric Oncology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Kataria, Tejinder
Basu, Trinanjan
Gupta, Deepak
Goyal, Shikha
Nasreen, Shahida
Bisht, Shyam S
Abhishek, Ashu
Banerjee, Susovan
Narang, Kushal
Jha, Ajaya N
Mohapatra, Ishani
Modi, Jayesh A
Modulated Radiotherapy with Concurrent and Adjuvant Temozolomide for Anaplastic Gliomas: Indian Single-center Data
title Modulated Radiotherapy with Concurrent and Adjuvant Temozolomide for Anaplastic Gliomas: Indian Single-center Data
title_full Modulated Radiotherapy with Concurrent and Adjuvant Temozolomide for Anaplastic Gliomas: Indian Single-center Data
title_fullStr Modulated Radiotherapy with Concurrent and Adjuvant Temozolomide for Anaplastic Gliomas: Indian Single-center Data
title_full_unstemmed Modulated Radiotherapy with Concurrent and Adjuvant Temozolomide for Anaplastic Gliomas: Indian Single-center Data
title_short Modulated Radiotherapy with Concurrent and Adjuvant Temozolomide for Anaplastic Gliomas: Indian Single-center Data
title_sort modulated radiotherapy with concurrent and adjuvant temozolomide for anaplastic gliomas: indian single-center data
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5759071/
https://www.ncbi.nlm.nih.gov/pubmed/29333019
http://dx.doi.org/10.4103/ijmpo.ijmpo_200_16
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