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Influence of molecular classification in anaplastic glioma for determining outcome and future approach to management.

Publication ,  Journal Article
Back, M; Jayamanne, DT; Brazier, D; Newey, A; Bailey, D; Schembri, GP; Hsiao, E; Khasraw, M; Wong, M; Kastelan, M; Guo, L; Clarke, S; Wheeler, H
Published in: J Med Imaging Radiat Oncol
April 2019

INTRODUCTION: Assess survival of patients with anaplastic glioma (AG) and the relationship to molecular subtype. METHODS: Patients with AG managed with IMRT between 2008 and 2014 were entered into a prospective database assessing relapse-free survival (RFS) and overall survival (OS). Isocitrate dehydrogenase (IDH) mutations were assessed prospectively from 2011, and subsequent testing of historical patients allowing categorisation under WHO 2016 classification as anaplastic astrocytoma IDH wild type (AAwt), anaplastic astrocytoma IDH mutated (AAmut), anaplastic oligodendroglioma (AOD) or other glial tumour (OTH). Kaplan-Meier estimates of survival distribution were calculated for the primary endpoint of overall survival and Log-rank test used to determine associated factors. RESULTS: One hundred and fifty-six patients were included with median follow-up for survivors of 4.7 years. Fifty-six per cent were managed after initial diagnosis, whilst 18% received IMRT at second or later relapse. Seventy-three per cent had temozolomide as part of initial therapy. A total of 118 or 75% of patients had IDH mutated glioma, of which 61 were AOD and 57 AAmut. There were 68 relapses and 52 deaths for a 6yrRFS of 51.2% and 6yrOS of 62.5%. AAwt was associated with worse survival (P < 0.001); and delay of RT until second or later relapse (P = 0.03). Within the 118 patients with IDH mutated tumours, 6yrOS for AOD and AAmut were 90.0% and 62.5%, respectively (P = 0.003). Also two or more craniotomies (P < 0.001), delayed RT (P = 0.006) and age <40 years (P = 0.022) were associated with worse survival on univariate analysis but only AAmut subtype and number of craniotomies on multivariate analysis. CONCLUSION: Within AG, molecular classification predicts for survival, and should influence current decision-making.

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Published In

J Med Imaging Radiat Oncol

DOI

EISSN

1754-9485

Publication Date

April 2019

Volume

63

Issue

2

Start / End Page

272 / 280

Location

Australia

Related Subject Headings

  • Treatment Outcome
  • Temozolomide
  • Survival Rate
  • Radiotherapy, Intensity-Modulated
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Back, M., Jayamanne, D. T., Brazier, D., Newey, A., Bailey, D., Schembri, G. P., … Wheeler, H. (2019). Influence of molecular classification in anaplastic glioma for determining outcome and future approach to management. J Med Imaging Radiat Oncol, 63(2), 272–280. https://doi.org/10.1111/1754-9485.12850
Back, Michael, Dasantha T. Jayamanne, David Brazier, Alison Newey, Dale Bailey, Geoffrey P. Schembri, Edward Hsiao, et al. “Influence of molecular classification in anaplastic glioma for determining outcome and future approach to management.J Med Imaging Radiat Oncol 63, no. 2 (April 2019): 272–80. https://doi.org/10.1111/1754-9485.12850.
Back M, Jayamanne DT, Brazier D, Newey A, Bailey D, Schembri GP, et al. Influence of molecular classification in anaplastic glioma for determining outcome and future approach to management. J Med Imaging Radiat Oncol. 2019 Apr;63(2):272–80.
Back, Michael, et al. “Influence of molecular classification in anaplastic glioma for determining outcome and future approach to management.J Med Imaging Radiat Oncol, vol. 63, no. 2, Apr. 2019, pp. 272–80. Pubmed, doi:10.1111/1754-9485.12850.
Back M, Jayamanne DT, Brazier D, Newey A, Bailey D, Schembri GP, Hsiao E, Khasraw M, Wong M, Kastelan M, Guo L, Clarke S, Wheeler H. Influence of molecular classification in anaplastic glioma for determining outcome and future approach to management. J Med Imaging Radiat Oncol. 2019 Apr;63(2):272–280.
Journal cover image

Published In

J Med Imaging Radiat Oncol

DOI

EISSN

1754-9485

Publication Date

April 2019

Volume

63

Issue

2

Start / End Page

272 / 280

Location

Australia

Related Subject Headings

  • Treatment Outcome
  • Temozolomide
  • Survival Rate
  • Radiotherapy, Intensity-Modulated
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans