Long-term survival and functional status of patients with low-grade astrocytoma of spinal cord

Clifford G. Robinson, Richard A. Prayson, Joseph F. Hahn, Iain H. Kalfas, Melvin D. Whitfield, Shih Yuan Lee, John H. Suh

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Purpose: To determine survival and changes in neurologic function and Karnofsky performance status (KPS) in a series of patients treated for low-grade astrocytoma of the spinal cord during the past two decades. Methods: This study consisted of 14 patients with pathologically confirmed low-grade astrocytoma of the spinal cord who were treated between 1980 and 2003. All patients underwent decompressive laminectomy followed by biopsy (n = 7), subtotal resection (n = 6), or gross total resection (n = 1). Ten patients underwent postoperative radiotherapy (median total dose 50 Gy in 28 fractions). The overall survival, progression-free survival, and changes in neurologic function and KPS were measured. Results: The overall survival rate at 5, 10, and 20 years was 100%, 75%, and 60%, respectively. The progression-free survival rate at 5, 10, and 20 years was 93%, 80%, and 60%, respectively. Neither overall survival nor progression-free survival was clearly correlated with any patient, tumor, or treatment factors. Neurologic function and KPS worsened after surgery in 8 (57%) of 14 and 9 (69%) of 13 patients, respectively. At a mean follow-up of 10.2 years, neurologic function had stabilized or improved in 8 (73%) of 11 remaining patients, but the KPS had worsened in 5 (50%) of 10. Most patients who were employed before surgery were working at last follow-up. Conclusion: Patients who undergo gross total resection of their tumor may be followed closely. Patients who undergo limited resection should continue to receive postoperative RT (50.4 Gy in 1.8-Gy fractions). The functional measures should be routinely evaluated to appreciate the treatment outcomes.

Original languageEnglish
Pages (from-to)91-100
Number of pages10
JournalInternational Journal of Radiation Oncology Biology Physics
Volume63
Issue number1
DOIs
StatePublished - Sep 1 2005
Externally publishedYes

Keywords

  • Astrocytoma
  • Radiotherapy
  • Spinal cord
  • Surgery

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