Impact of 1p/19q codeletion and histology on outcomes of Anaplastic gliomas treated with radiation therapy and temozolomide

Christina K. Speirs, Joseph R. Simpson, Clifford G. Robinson, Todd A. Dewees, David D. Tran, Gerry Linette, Michael R. Chicoine, Ralph G. Dacey, Keith M. Rich, Joshua L. Dowling, Eric C. Leuthardt, Gregory J. Zipfel, Albert H. Kim, Jiayi Huang

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Purpose: Anaplastic gliomas represent a heterogeneous group of primary high-grade brain tumors, and the optimal postoperative treatment remains controversial. In this report, we present our institutional data on the clinical outcomes of radiation therapy (RT) plus temozolomide (RT + TMZ) for anaplastic gliomas, stratified by histology and 1p/19q codeletion. Methods and Materials: A single-institution retrospective review was conducted of patients with supratentorial anaplastic oligodendroglioma (AO), mixed anaplastic oligoastrocytoma (AOA), and anaplastic astrocytoma (AA). After surgery, RT was delivered at a median total dose of 60 Gy (range, 31.6-63 Gy) in daily fractions. All patients received standard concurrent TMZ, with or without adjuvant TMZ. Histological/molecular subtypes were defined as codeleted AO/AOA, non-codeleted AO/AOA, and AA. Results: From 2000 to 2012, 111 cases met study criteria and were evaluable. Codeleted AO/AOA had superior overall survival (OS) to non-codeleted AO/AOA (91% vs 68% at 5 years, respectively, P=.02), whereas progression-free survival (PFS) was not significantly different (70% vs 46% at 5 years, respectively, P=.10). AA had inferior OS to non-codeleted AO/AOA (37% vs 68% at 5 years, respectively, P=.007) and inferior PFS (27% vs 46%, respectively, PZ.03). On multivariate analysis, age, performance status, and histological or molecular subtype were independent predictors for both PFS and OS. Compared to historical controls, RT + TMZ provided comparable OS to RT with procarbazine, lomustine, and vincristine (RT + PCV) for codeleted AO/AOA, superior OS to RT alone for non-codeleted AO/AOA, and similar OS to RT alone for AA. Conclusions: RT + TMZ may be a promising treatment for both codeleted and noncodeleted AO/AOA, but its role for AA remains unclear.

Original languageEnglish (US)
Pages (from-to)268-276
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume91
Issue number2
DOIs
StatePublished - 2015

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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