Authors: Benjamin W Corn Meihua Wang Sherry Fox Jeffrey Michalski James Purdy Joseph Simpson John Kresl Walter J Curran Aidnag Diaz Minesh Mehta Benjamin Movsas
Publish Date: 2009/11/01
Volume: 95, Issue: 2, Pages: 247-257
Abstract
The Radiation Therapy Oncology Group RTOG embarked on a phase I/II study of patients suffering from glioblastoma multiforme protocol 9803 to assess the impact of dose escalation with 3D conformal techniques The primary endpoints were feasibility and survival This report describes the outcome of secondary endpoints quality of life and neurocognitive function Patients with supratentorial GBM were treated with a combination of carmustine BCNU and conformal irradiation dose levels 66 72 78 84 Gy respectively Quality of Life was assessed with the Spitzer Quality of Life Index Neurocognitive function was determined by the Mini Mental Status Examination The latter tests were administered at the start of irradiation at the end of irradiation and then at 4 month intervals Relatively high compliance was achieved with both of the tools SQLI MMSE Overall rates of survival between baseline SQLI scores 7 and 7–10 were statistically significantly different HR = 172 95 CI 122 24 P = 00015 The significant impact of high SQLI score on survival was preserved in multivariate analysis The component of this index which made the greatest contribution was the patient’s independence There was continual deterioration of neurocognitive function within the populations studied No correlation was seen between dose escalation and the secondary endpoints studied Radiation dose escalation and assessment of its impact on life quality and neurocognition can be carried out in a large international trial Baseline SQLI is a statistically significant determinant of survival Those who maintain independence have superior survival to those who are reliant on others
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