Background
Patients and methods
Patients and inclusion criteria
Radiooncological treatment and follow up
Endpoints
Results and discussion
Patient characteristics and outcome of therapy
All patients | ||
---|---|---|
Characteristics | Number | Percentage |
Age at diagnosis, median (range) [years] | 62 (23–86) | |
ECOG-status before radiotherapy | ||
0 (KPS 90–100) | 55 | 14.9 |
1 (KPS 70–90) | 230 | 62.3 |
2 (KPS < 70) | 84 | 22.8 |
RPA class before radiotherapy | ||
III | 21 | 5.7 |
IV | 192 | 52.0 |
V | 152 | 41.2 |
Unknown | 4 | 1.1 |
MGMT promoter status | ||
Unmethylated | 30 | 8.1 |
Methylated | 23 | 6.2 |
Unknown | 316 | 85.6 |
Extent of resection | ||
Gross total resection | 176 | 47.7 |
Partial resection | 155 | 42.0 |
Biopsy only | 24 | 6.5 |
Undeterminable | 14 | 3.8 |
Simultaneous chemotherapy | 248 | 67.2 |
Fractionation | ||
33 × 1.8 Gy ∑ 59.4 Gy | 187 | 50.7 |
30 × 2.0 Gy ∑ 60.0 Gy | 182 | 49.3 |
Prognostic parameters
OS | PFS | |||
---|---|---|---|---|
All patients | All patients | |||
HR (95 % CI) |
p-value | Factors | HR (95 % CI) |
p-value |
0.991 (0.981-1.001) | 0.089 | Interval surgery → RCT | 0.994 (0.985-1.003) | 0.188 |
1.017 (0.985-1.049) | 0.303 | Radiation treatment time | 1.008 (0.978-1.039) | 0.616 |
0.994 (0.985-1.003) | 0.198 | Overall duration of treatment | 0.995 (0.987-1.004) | 0.277 |
1.037 (1.026-1.048) | <0.001 | Age | 1.025 (1.016-1.035) | <0.001 |
1.389 (1.062-1.816) | 0.016 | ECOG state ≤ 1 vs > 1 | 1.241 (0.957-1.610) | 0.104 |
1.768 (1.397-2.236) | <0.001 | RPA-class ≤ 4 vs > 4 | 1.650 (1.315-2.070) | <0.001 |
1.825 (1.440-2.314) | <0.001 | Resection status (total vs. subtotal) | 1.560 (1.248-1.951) | <0.001 |
0.604 (0.474-0.769) | <0.001 | Simultaneous CT | 0.669 (0.528-0.848) | 0.001 |
0.888 (0.703-1.122) | 0.321 | Fractionation | 1.002 (0.806-1.246) | 0.984 |
0.312 (0.120-0.813) | 0.017 | MGMT methylation | 0.447 (0.220-0.909) | 0.026 |
OS | All patients | Fractionation 33 × 1.8 Gy | Fractionation 30 × 2.0 Gy | |||
---|---|---|---|---|---|---|
Factor | HR (95 % CI) |
p-value | HR (95 % CI) |
p-value | HR (95 % CI) |
p-value |
Interval surgery → RCT | 0.998 (0.987-1.009) | 0.705 | 0.985 (0.970-1.001) | 0.059 | 1.007 (0.994-1.020) | 0.312 |
Age | 1.033 (1.020-1.045) | <0.001 | 1.031 (1.015-1.047) | <0.001 | 1.040 (1.019-1.061) | <0.001 |
ECOG state > 1 | 0.984 (0.728-1.364) | 0.984 | 0.956 (0.638-1.431) | 0.522 | 0.974 (0.580-1.636) | 0.920 |
RPA-class > 4 | 1.210 (0.905-1.617) | 0.199 | 1.240 (0.862-1.784) | 0.247 | 1.159 (0.702-1.912) | 0.564 |
Incomplete resection | 1.886 (1.481-2.402) | <0.001 | 1.588 (1.152-2.189) | 0.005 | 2.265 (1.533-3.347) | <0.001 |
Simultaneous CT | 0.573 (0.427-0.767) | <0.001 | 0.592 (0.419-0.837) | 0.003 | 0.535 (0.308-0.929) | 0.026 |
Fractionation | 1.061 (0.807-1.396) | 0.672 | - | - | - | - |
Radiation treatment time | 1.025 (0.985-1.068) | 0.225 | 1.013 (0.960-1.070) | 0.634 | 1.029 (0.964-1.098) | 0.394 |
Age | 1.034 (1.021-1.047) | <0.001 | 1.031 (1.015-1.047) | <0.001 | 1.040 (1.019-1.061) | <0.001 |
ECOG state > 1 | 1.006 (0.739-1.371) | 0.968 | 1.027 (0.692-1.525) | 0.893 | 0.947 (0.565-1.586) | 0.835 |
RPA-class > 4 | 1.222 (0.914-1.634) | 0.175 | 1.244 (0.692-1.790) | 0.239 | 1.157 (0.700-1.913) | 0.570 |
Incomplete resection | 1.927 (1.510-2.460) | <0.001 | 1.642 (1.183-2.278) | 0.003 | 2.301 (1.558-3.399) | <0.001 |
Simultaneous CT | 0.584 (0.437-0.782) | <0.001 | 0.570 (0.405-1.801) | 0.001 | 0.581 (0.335-1.009) | 0.054 |
Fractionation | 1.175 (0.865-1.595) | 0.302 | - | - | - | - |
Overall duration of treatment | 1.000 (0.989-1.010) | 0.939 | 0.987 (0.971-1.002) | 0.084 | 1.008 (0.995-1.021) | 0.239 |
Age | 1.033 (1.020-1.045) | <0.001 | 1.030 (1.014-1.046) | <0.001 | 1.040 (1.019-1.061) | <0.001 |
ECOG state > 1 | 1.005 (0.735-1.375) | 0.974 | 0.858 (0.644-1.443) | 0.858 | 0.976 (0.581-1.640) | 0.928 |
RPA-class > 4 | 1.209 (0.905-1.616) | 0.199 | 1.231 (0.855-1.773) | 0.263 | 1.169 (0.708-1.931) | 0.542 |
Incomplete resection | 1.884 (1.479-2.399) | <0.001 | 1.571 (1.139-2.166) | 0.006 | 2.256 (1.527-3.333) | <0.001 |
Simultaneous CT | 0.568 (0.424-0.759) | <0.001 | 0.582 (0.413-0.821) | 0.002 | 0.535 (0.308-0.928) | 0.026 |
Fractionation | 1.068 (0.805-1.418) | 0.648 | - | - | - | - |
PFS | All patients | Fractionation 33 × 1.8 Gy | Fractionation 30 × 2.0 Gy | |||
---|---|---|---|---|---|---|
Factor | HR (95 % CI) |
p-value | HR (95 % CI) |
p-value | HR (95 % CI) |
p-value |
Interval surgery → RCT | 1.000 (0.991-1.010) | 0.943 | 0.999 (0.985-1.014) | 0.896 | 1.000 (0.987-1.014) | 0.984 |
Age | 1.021 (1.010-1.032) | <0.001 | 1.022 (1.007-1.036) | 0.003 | 1.021 (1.005-1.037) | 0.009 |
ECOG state > 1 | 0.965 (0.712-1.307) | 0.817 | 0.931 (0.618-1.403) | 0.733 | 0.987 (0.617-1.581) | 0.958 |
RPA-class > 4 | 1.191 (0.898-1.579) | 0.225 | 1.062 (0.731-1.543) | 0.751 | 1.237 (0.789-1.937) | 0.354 |
Incomplete resection | 1.498 (1.193-1.881) | 0.001 | 1.126 (0.812-1.560) | 0.477 | 1.889 (1.347-2.647) | <0.001 |
Simultaneous CT | 0.653 (0.488-0.874) | 0.004 | 0.572 (0.398-0.823) | 0.003 | 0.652 (0.381-1.116) | 0.119 |
Fractionation | 1.117 (0.865-1.443) | 0.396 | - | - | - | - |
Radiation treatment time | 1.010 (0.972-1.049) | 0.681 | 1.008 (0.956-1.064) | 0.762 | 0.997 (0.943-1.055) | 0.928 |
Age | 1.021 (1.011-1.032) | <0.001 | 1.022 (1.008-1.037) | 0.003 | 1.021 (1.005-1.037) | 0.009 |
ECOG state > 1 | 0.971 (0.791-1.310) | 0.846 | 0.945 (0.631-1.415) | 0.785 | 0.985 (0.619-1.569) | 0.950 |
RPA-class > 4 | 1.194 (0.901-1.583) | 0.218 | 1.070 (0.736-1.554) | 0.749 | 1.236 (0.790-1.936) | 0.354 |
Incomplete resection | 1.510 (1.201-1.899) | <0.001 | 1.076 (0.779-1.485) | 0.435 | 1.890 (1.350-2.644) | <0.001 |
Simultaneous CT | 0.663 (0.496-0.884) | 0.005 | 0.579 (0.402-0.832) | 0.003 | 0.652 (0.383-1.110) | 0.115 |
Fractionation | 1.158 (0.866-1.548) | 0.324 | - | - | - | - |
Overall duration of treatment | 1.001 (0.992-1.010) | 0.847 | 1.000 (0.986-1.014) | 0.960 | 1.000 (0.987-1.013) | 0.999 |
Age | 1.021 (1.010-1.032) | <0.001 | 1.022 (1.007-1.036) | 0.003 | 1.021 (1.005-1.037) | 0.009 |
ECOG state > 1 | 0.969 (0.714-1.314) | 0.838 | 0.934 (0.619-1.411) | 0.747 | 0.986 (0.616-1.581) | 0.955 |
RPA-class > 4 | 1.191 (0.898-1.579) | 0.225 | 1.062 (0.731-1.542) | 0.754 | 1.236 (0.789-1.937) | 0.354 |
Incomplete resection | 1.498 (1.193-1.881) | 0.001 | 1.126 (0.812-1.562) | 0.477 | 1.889 (1.348-2.648) | <0.001 |
Simultaneous CT | 0.652 (0.488-0.871) | 0.004 | 0.570 (0.397-0.819) | 0.002 | 0.652 (0.381-1.116) | 0.119 |
Fractionation | 1.123 (0.864-1.458) | 0.385 | - | - | - | - |