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Impact of adjuvant treatments on survival in Korean patients with WHO grade II gliomas: KNOG 15-02 and KROG 16-04 intergroup study

 Taeryool Koo  ;  Do Hoon Lim  ;  Ho Jun Seol  ;  Yun-Sik Dho  ;  Il Han Kim  ;  Jong Hee Chang  ;  Jeongshim Lee  ;  Tae-Young Jung  ;  Ho-Shin Gwak  ;  Kwan Ho Cho  ;  Chang-Ki Hong  ;  Ik Jae Lee  ;  El Kim  ;  Jin Hee Kim  ;  Yong-Kil Hong  ;  Hong Seok Jang  ;  Chae-Yong Kim  ;  In Ah Kim  ;  Sung Hwan Kim  ;  Young Il Kim  ;  Eun-Young Kim  ;  Woo Chul Kim  ;  Semie Hong 
 JOURNAL OF NEURO-ONCOLOGY, Vol.140(2) : 445-455, 2018 
Journal Title
Issue Date
Adult ; Aged ; Brain Neoplasms/diagnosis* ; Brain Neoplasms/mortality ; Brain Neoplasms/pathology ; Brain Neoplasms/therapy* ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Glioma/diagnosis* ; Glioma/mortality ; Glioma/pathology ; Glioma/therapy* ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Prognosis ; Radiotherapy, Adjuvant ; Republic of Korea
Adjuvant treatment ; Chemotherapy ; Low-grade glioma ; Radiotherapy ; Survival
INTRODUCTION: Optimal treatment strategies for low-grade glioma (LGG) remain controversial. We analyzed treatment outcomes and evaluated prognostic factors of adult LGG patients in Korea.

METHODS: We reviewed the medical records of 555 patients diagnosed with WHO grade II LGG (astrocytoma 37.8%, oligoastrocytoma 15.3%, and oligodendroglioma 46.8%) at 14 institutions between 2000 and 2010. Primary and secondary endpoints were progression-free survival (PFS) and overall survival (OS). Propensity-score matching (PSM) analyses were performed to correct imbalances in patient/tumor characteristics among adjuvant treatment groups.

RESULTS: The median follow-up time was 83.4 months, and the 5-year PFS and OS rates were 52.2% and 83.0%, respectively. Male, older age, poorer performance status, multiple lobe involvement, and astrocytoma histology were associated with poorer survival. Among the treatment factors, gross total resection (GTR) was associated with better PFS and OS, and adjuvant chemotherapy with improved PFS. Interestingly, adjuvant radiotherapy (RT) did not improve PFS; rather, it was related with poorer OS. Regarding patient/tumor characteristics, the RT group had poorer characteristics than the non-RT group. After PSM, we detected a tendency for improved PFS in the matched RT group, and no significant difference in OS compared with the matched non-RT group.

CONCLUSIONS: The achievement of GTR is important to improve survival in LGG patients. Adjuvant chemotherapy may enhance PFS, but adjuvant RT did not improve survival outcomes. After PSM, we observed potential impacts of adjuvant RT on PFS. Our results may reflect real-world practice and consequently may help to optimize treatment strategies for LGG.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Lee, Jeong Shim(이정심)
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Hong, Chang Ki(홍창기) ORCID logo https://orcid.org/0000-0002-2761-0373
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