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Journal of Neuro-Oncology

, Volume 140, Issue 2, pp 445–455 | Cite as

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
Clinical Study

Abstract

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.

Keywords

Low-grade glioma Survival Adjuvant treatment Radiotherapy Chemotherapy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human data were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

11060_2018_2972_MOESM1_ESM.pptx (188 kb)
Supplementary material 1 (PPTX 188 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Taeryool Koo
    • 1
  • Do Hoon Lim
    • 2
  • Ho Jun Seol
    • 3
  • Yun-Sik Dho
    • 4
  • Il Han Kim
    • 5
  • Jong Hee Chang
    • 6
  • Jeongshim Lee
    • 7
  • Tae-Young Jung
    • 8
  • Ho-Shin Gwak
    • 9
  • Kwan Ho Cho
    • 10
  • Chang-Ki Hong
    • 11
  • Ik Jae Lee
    • 12
  • El Kim
    • 13
  • Jin Hee Kim
    • 14
  • Yong-Kil Hong
    • 15
  • Hong Seok Jang
    • 16
  • Chae-Yong Kim
    • 17
  • In Ah Kim
    • 18
  • Sung Hwan Kim
    • 19
  • Young Il Kim
    • 20
  • Eun-Young Kim
    • 21
  • Woo Chul Kim
    • 22
  • Semie Hong
    • 23
  1. 1.Department of Radiation OncologyHallym University Sacred Heart HospitalAnyangSouth Korea
  2. 2.Department of Radiation Oncology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  3. 3.Department of Neurosurgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  4. 4.Department of NeurosurgerySeoul National University College of MedicineSeoulSouth Korea
  5. 5.Department of Radiation OncologySeoul National University College of MedicineSeoulSouth Korea
  6. 6.Department of Neurosurgery, Yonsei Cancer CenterYonsei University College of MedicineSeoulSouth Korea
  7. 7.Department of Radiation Oncology, Yonsei Cancer CenterYonsei University College of MedicineSeoulSouth Korea
  8. 8.Department of NeurosurgeryChonnam National University Medical School, Chonnam National University Hwasun HospitalHwasunSouth Korea
  9. 9.Department of System Cancer Science, Graduate School of Cancer Science and PolicyNational Cancer CenterGoyangSouth Korea
  10. 10.Proton Therapy Center, Research Institute and HospitalNational Cancer CenterGoyangSouth Korea
  11. 11.Department of Neurosurgery, Brain Tumor Center, Gangnam Severance HospitalYonsei University College of MedicineSeoulSouth Korea
  12. 12.Department of Radiation Oncology, Gangnam Severance HospitalYonsei University College of MedicineSeoulSouth Korea
  13. 13.Department of Neurosurgery, Dongsan Medical CenterKeimyung University School of MedicineDaeguSouth Korea
  14. 14.Department of Radiation Oncology, Dongsan Medical CenterKeimyung University School of MedicineDaeguSouth Korea
  15. 15.Department of Neurosurgery, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
  16. 16.Department of Radiation Oncology, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
  17. 17.Department of Neurosurgery, Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnamSouth Korea
  18. 18.Department of Radiation Oncology, Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnamSouth Korea
  19. 19.Department of Radiation Oncology, St. Vincent Hospital, College of MedicineThe Catholic University of KoreaSuwonSouth Korea
  20. 20.Department of Radiation OncologyChungnam National University School of MedicineDaejeonSouth Korea
  21. 21.Department of Neurosurgery, Inha University HospitalInha University of MedicineInchonSouth Korea
  22. 22.Department of Radiation Oncology, Inha University HospitalInha University of MedicineInchonSouth Korea
  23. 23.Department of Radiation Oncology, Konkuk University Medical Center, School of MedicineKonkuk UniversitySeoulSouth Korea

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