Back to Search
Start Over
Clinical and treatment factors determining long-term outcomes for adult survivors of childhood low-grade glioma: A population-based study.
- Source :
-
Cancer (0008543X) . Apr2016, Vol. 122 Issue 8, p1261-1269. 9p. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>The determinants of outcomes for adult survivors of pediatric low-grade glioma (PLGG) are largely unknown.<bold>Methods: </bold>This study collected population-based follow-up information for all PLGG patients diagnosed in Ontario, Canada from 1985 to 2012 (n = 1202) and determined factors affecting survival. The impact of upfront radiation treatment on overall survival (OS) was determined for a cohort of Ontario patients and an independent reference cohort from the Surveillance, Epidemiology, and End Results database.<bold>Results: </bold>At a median follow-up of 12.73 years (range, 0.02-33 years), only 93 deaths (7.7%) were recorded, and the 20-year OS rate was 90.1% ± 1.1%. Children with neurofibromatosis type 1 had excellent survival and no tumor-related deaths during adulthood. Adverse risk factors included pleomorphic xanthoastrocytoma (P < .001) and a thalamic location (P < .001). For patients with unresectable tumors surviving more than 5 years after the diagnosis, upfront radiotherapy was associated with an approximately 3-fold increased risk of overall late deaths (hazard ratio [HR], 3.3; 95% confidence interval [CI], 1.6-6.6; P = .001) and an approximately 4-fold increased risk of tumor-related deaths (HR, 4.4; 95% CI, 1.3-14.6; P = .013). In a multivariate analysis, radiotherapy was the most significant factor associated with late all-cause deaths (HR, 3.0; 95% CI, 1.3-7.0; P = .012) and tumor-related deaths (HR, 4.4; 95% CI, 1.3-14.6; P = 0.014). A similar association between radiotherapy and late deaths was observed in the independent reference cohort (P < .001). In contrast to early deaths, late mortality was associated not with PLGG progression but rather with tumor transformation and non-oncological causes.<bold>Conclusions: </bold>The course of PLGG is associated with excellent long-term survival, but this is hampered by increased delayed mortality in patients receiving upfront radiotherapy. These observations should be considered when treatment options are being weighed for these patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- *GLIOMAS
*NERVOUS system tumors
*ASTROCYTOMAS
*GLIOBLASTOMA multiforme
*MEDULLOBLASTOMA
*BRAIN tumor treatment
*GLIOMA treatment
*AGE distribution
*BRAIN tumors
*CANCER relapse
*CANCER invasiveness
*CONFIDENCE intervals
*DATABASES
*LONGITUDINAL method
*MULTIVARIATE analysis
*PROGNOSIS
*REGRESSION analysis
*SEX distribution
*SURVIVAL analysis (Biometry)
*TIME
*TUMOR classification
*ACQUISITION of data
*PROPORTIONAL hazards models
*RETROSPECTIVE studies
*KAPLAN-Meier estimator
Subjects
Details
- Language :
- English
- ISSN :
- 0008543X
- Volume :
- 122
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- Cancer (0008543X)
- Publication Type :
- Academic Journal
- Accession number :
- 114437059
- Full Text :
- https://doi.org/10.1002/cncr.29907