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Volume 13, Number 1, 2008

Tumour surface area as a prognostic factor in primary and recurrent glioblastoma irradiated with 192Ir implantation

Andrzej Lebioda, Agnieszka Żyromska, Roman Makarewicz, Jacek Furtak

Summary:

Background To evaluate the impact of tumour surface area (TSA) on survival of patients treated with 192Ir implantation for glioblastoma multiforme (GBM).
Methods/Materials The analysis of survival and prognostic factors was performed based on a retrospective study group of 120 patients (74 males and 46 females; mean age 53 years;
mean KPS score 74.6) irradiated with 192Ir for GBM between 1999 and 2003. There
were 72 (60%) patients with recurrent and 48 (40%) with primary inoperable tumour.
Patients with recurrences were initially treated with surgery and external beam radiotherapy (EBRT; mean total dose (MTD) 53.5Gy). Individuals with primary inoperable glioblastoma underwent EBRT (MTD 37.2Gy) after brachytherapy completion. All patients were irradiated with 192Ir with a total dose of 15Gy given in 5 fractions.
Results For the total group of patients 1-year and 2-year survival were 22% and 11%, respectively, with a median survival time (MST) of 6.1 months. The multivariate Cox analysis of the best fi t (Chi²=22.98, p=0.000041) distinguished such variables as: patient age (p=0.002), performance status (p=0.04) and tumour surface area (p=0.04) to signifi cantly affect survival. Patients with TSA<90 cm2 had better prognosis compared to those with TSA≥90cm2 (p<0.001).
Conclusions Tumour surface area is an independent prognostic factor in patients irradiated
with 192Ir for glioblastoma multiforme. TSA less than 90cm2 predicts signifi cantly
longer survival and appears to be a more powerful prognostic variable than tumour
volume.

Signature: Rep Pract Oncol Radiother, 2008; 13(1) : 15-22

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http://www.sciencedirect.com/science/journal/15071367/19/2