Interstitial irradiation versus interstitial thermoradiotherapy for supratentorial malignant gliomas: A comparative survival analysis

Baldassarre Stea, Kent Rossman, John Kittelson, Andrew Shetter, Allan J Hamilton, J. Robert Cassady

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Purpose: To compare the survival of two groups of patients with supratentorial malignant gliomas who were treated on two sequential protocols with either interstitial thermoradiotherapy or with interstitial irradiation without hyperthermia. 1Methods and Materials: Between 1988-1992, patients with anaplastic astrocytoma or glioblastoma multiforme were treated at the University of Arizona on a Phase I/II protocol of interstitial thermoradiotherapy with ferromagnetic seeds. The treatment protocol consisted of debulking surgery, a course of external beam radiotherapy and hyperthermia given immediately before and after brachytherapy. The survival of patients so treated was compared with that of a similar group of patients treated with interstitial brachytherapy alone at the Barrows Neurological Institute between 1982-1990. Results: Twenty-five patients with primary tumors treated at the time of initial presentation with thermoradiotherapy were compared with a control group of 37 patients treated with interstitial brachytherapy alone. All primary patients were followed for a minimum of 34 months post implant. Multivariate analysis based on proportional hazards models showed that hyperthermia (p = 0.027), patient age (p ≤ 0.00001) and histology (anaplastic astrocytoma vs. glioblastoma multiforme, p = 0.0017) were the only factors significantly associated with survival in this data set. From the fitted model, the hazard of dying when treated with hyperthermia was .53 times (95% confidence intervals 0.29-0.94) than that of the control group. In addition, we treated a small group of patients with recurrent tumors (13 with brachytherapy alone, and eight with thermoradiotherapy) and found no survival difference (p = 0.62). Conclusion: Within the constraints of the selection factors and the different treatment parameters used in these studies, we conclude that an interstitial thermoradiotherapy boost confers a statistically significant survival benefit to patients with primary high grade gliomas when compared to interstitial brachytherapy alone.

Original languageEnglish (US)
Pages (from-to)591-600
Number of pages10
JournalInternational Journal of Radiation Oncology Biology Physics
Volume30
Issue number3
DOIs
StatePublished - Oct 15 1994

Fingerprint

Survival Analysis
Glioma
interstitials
irradiation
Brachytherapy
hyperthermia
Fever
Survival
Astrocytoma
Glioblastoma
Proportional Hazards Models
hazards
tumors
Control Groups
histology
Clinical Protocols
acceleration (physics)
surgery
seeds
confidence

Keywords

  • Hyperthermia
  • Interstitial brachytherapy
  • Malignant gliomas

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Interstitial irradiation versus interstitial thermoradiotherapy for supratentorial malignant gliomas : A comparative survival analysis. / Stea, Baldassarre; Rossman, Kent; Kittelson, John; Shetter, Andrew; Hamilton, Allan J; Cassady, J. Robert.

In: International Journal of Radiation Oncology Biology Physics, Vol. 30, No. 3, 15.10.1994, p. 591-600.

Research output: Contribution to journalArticle

@article{f108ca2f8fff4ae59978641e71503032,
title = "Interstitial irradiation versus interstitial thermoradiotherapy for supratentorial malignant gliomas: A comparative survival analysis",
abstract = "Purpose: To compare the survival of two groups of patients with supratentorial malignant gliomas who were treated on two sequential protocols with either interstitial thermoradiotherapy or with interstitial irradiation without hyperthermia. 1Methods and Materials: Between 1988-1992, patients with anaplastic astrocytoma or glioblastoma multiforme were treated at the University of Arizona on a Phase I/II protocol of interstitial thermoradiotherapy with ferromagnetic seeds. The treatment protocol consisted of debulking surgery, a course of external beam radiotherapy and hyperthermia given immediately before and after brachytherapy. The survival of patients so treated was compared with that of a similar group of patients treated with interstitial brachytherapy alone at the Barrows Neurological Institute between 1982-1990. Results: Twenty-five patients with primary tumors treated at the time of initial presentation with thermoradiotherapy were compared with a control group of 37 patients treated with interstitial brachytherapy alone. All primary patients were followed for a minimum of 34 months post implant. Multivariate analysis based on proportional hazards models showed that hyperthermia (p = 0.027), patient age (p ≤ 0.00001) and histology (anaplastic astrocytoma vs. glioblastoma multiforme, p = 0.0017) were the only factors significantly associated with survival in this data set. From the fitted model, the hazard of dying when treated with hyperthermia was .53 times (95{\%} confidence intervals 0.29-0.94) than that of the control group. In addition, we treated a small group of patients with recurrent tumors (13 with brachytherapy alone, and eight with thermoradiotherapy) and found no survival difference (p = 0.62). Conclusion: Within the constraints of the selection factors and the different treatment parameters used in these studies, we conclude that an interstitial thermoradiotherapy boost confers a statistically significant survival benefit to patients with primary high grade gliomas when compared to interstitial brachytherapy alone.",
keywords = "Hyperthermia, Interstitial brachytherapy, Malignant gliomas",
author = "Baldassarre Stea and Kent Rossman and John Kittelson and Andrew Shetter and Hamilton, {Allan J} and Cassady, {J. Robert}",
year = "1994",
month = "10",
day = "15",
doi = "10.1016/0360-3016(92)90945-E",
language = "English (US)",
volume = "30",
pages = "591--600",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Interstitial irradiation versus interstitial thermoradiotherapy for supratentorial malignant gliomas

T2 - A comparative survival analysis

AU - Stea, Baldassarre

AU - Rossman, Kent

AU - Kittelson, John

AU - Shetter, Andrew

AU - Hamilton, Allan J

AU - Cassady, J. Robert

PY - 1994/10/15

Y1 - 1994/10/15

N2 - Purpose: To compare the survival of two groups of patients with supratentorial malignant gliomas who were treated on two sequential protocols with either interstitial thermoradiotherapy or with interstitial irradiation without hyperthermia. 1Methods and Materials: Between 1988-1992, patients with anaplastic astrocytoma or glioblastoma multiforme were treated at the University of Arizona on a Phase I/II protocol of interstitial thermoradiotherapy with ferromagnetic seeds. The treatment protocol consisted of debulking surgery, a course of external beam radiotherapy and hyperthermia given immediately before and after brachytherapy. The survival of patients so treated was compared with that of a similar group of patients treated with interstitial brachytherapy alone at the Barrows Neurological Institute between 1982-1990. Results: Twenty-five patients with primary tumors treated at the time of initial presentation with thermoradiotherapy were compared with a control group of 37 patients treated with interstitial brachytherapy alone. All primary patients were followed for a minimum of 34 months post implant. Multivariate analysis based on proportional hazards models showed that hyperthermia (p = 0.027), patient age (p ≤ 0.00001) and histology (anaplastic astrocytoma vs. glioblastoma multiforme, p = 0.0017) were the only factors significantly associated with survival in this data set. From the fitted model, the hazard of dying when treated with hyperthermia was .53 times (95% confidence intervals 0.29-0.94) than that of the control group. In addition, we treated a small group of patients with recurrent tumors (13 with brachytherapy alone, and eight with thermoradiotherapy) and found no survival difference (p = 0.62). Conclusion: Within the constraints of the selection factors and the different treatment parameters used in these studies, we conclude that an interstitial thermoradiotherapy boost confers a statistically significant survival benefit to patients with primary high grade gliomas when compared to interstitial brachytherapy alone.

AB - Purpose: To compare the survival of two groups of patients with supratentorial malignant gliomas who were treated on two sequential protocols with either interstitial thermoradiotherapy or with interstitial irradiation without hyperthermia. 1Methods and Materials: Between 1988-1992, patients with anaplastic astrocytoma or glioblastoma multiforme were treated at the University of Arizona on a Phase I/II protocol of interstitial thermoradiotherapy with ferromagnetic seeds. The treatment protocol consisted of debulking surgery, a course of external beam radiotherapy and hyperthermia given immediately before and after brachytherapy. The survival of patients so treated was compared with that of a similar group of patients treated with interstitial brachytherapy alone at the Barrows Neurological Institute between 1982-1990. Results: Twenty-five patients with primary tumors treated at the time of initial presentation with thermoradiotherapy were compared with a control group of 37 patients treated with interstitial brachytherapy alone. All primary patients were followed for a minimum of 34 months post implant. Multivariate analysis based on proportional hazards models showed that hyperthermia (p = 0.027), patient age (p ≤ 0.00001) and histology (anaplastic astrocytoma vs. glioblastoma multiforme, p = 0.0017) were the only factors significantly associated with survival in this data set. From the fitted model, the hazard of dying when treated with hyperthermia was .53 times (95% confidence intervals 0.29-0.94) than that of the control group. In addition, we treated a small group of patients with recurrent tumors (13 with brachytherapy alone, and eight with thermoradiotherapy) and found no survival difference (p = 0.62). Conclusion: Within the constraints of the selection factors and the different treatment parameters used in these studies, we conclude that an interstitial thermoradiotherapy boost confers a statistically significant survival benefit to patients with primary high grade gliomas when compared to interstitial brachytherapy alone.

KW - Hyperthermia

KW - Interstitial brachytherapy

KW - Malignant gliomas

UR - http://www.scopus.com/inward/record.url?scp=0027933781&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027933781&partnerID=8YFLogxK

U2 - 10.1016/0360-3016(92)90945-E

DO - 10.1016/0360-3016(92)90945-E

M3 - Article

C2 - 7928490

AN - SCOPUS:0027933781

VL - 30

SP - 591

EP - 600

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 3

ER -