Patterns of care and outcomes for use of concurrent chemoradiotherapy over radiotherapy alone for anaplastic gliomas

Publication date: Available online 17 October 2017
Source:Radiotherapy and Oncology
Author(s): Debra Nana Yeboa, Charles E. Rutter, Henry S. Park, Nataniel H. Lester-Coll, Christopher D. Corso, Brandon R. Mancini, Ranjit S. Bindra, Joseph Contessa, James B. Yu
Background and purposeThe role of concurrent chemoradiotherapy (CRT) for anaplastic gliomas is undefined and patterns of care are under-reported. To address the knowledge gap, we examined use of CRT for grade III gliomas compared to radiotherapy (RT) alone.Material and methodsIn an observational study design cohort from the National Cancer Database, we identified 4437 adult patients receiving surgery followed by either CRT or RT for supratentorial anaplastic glioma in 2003–2011. Univariable and multivariable logistic regression analyses were used to assess factors associated with use of CRT. Overall survival (OS) was assessed by the Kaplan–Meier analysis with log-rank tests, Cox proportional hazards regression modeling, and propensity score matching.ResultsReceipt of CRT (vs. RT) was associated with recent year of diagnosis (OR for 2011 (vs. 2003) 3.36, 95% CI 2.49–4.54) and having astrocytoma (vs. oligodendroglioma) (OR 1.37, 95% CI 1.15–1.63). Patients receiving CRT had a lower adjusted hazard of death (hazard ratio 0.72, 95% CI 0.65–0.79). Outcomes were worse for patients ≥60 (HR 6.94, 95% CI 6.09–7.91) and astrocytomas (HR 2.08, 95% CI 1.85–2.34).ConclusionUse of concurrent CRT is associated with more recent year of diagnosis and improved survival relative to RT alone.



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