RESUMO
PURPOSE: To determine the impact of postoperative radiation therapy (POXRT) on outcome in spinal cord gliomas. PATIENTS AND METHODS: Data from 242 patients were collected retrospectively from six institutions using a standardized data sheet. Pathology specimens, when available, were centrally reviewed. RESULTS: A total of 183 patients were analyzed: 82 received surgery alone as initial treatment, whereas 101 had surgery and POXRT. Demographic, diagnostic, and treatment factors were analyzed for impact on progression-free (PFS) and overall survival (OS). PFS in ependymoma patients was 74%, 60%, and 35% at 5, 10, 15 years, respectively, and was significantly influenced by treatment type, race, age, tumor grade, and type of surgery on univariate analysis, with age being the only significant factor on multivariate analysis (MVA) (p = 0.01). OS of ependymoma patients was 91%, 84%, and 75% at 5, 10, and 15 years, respectively, and was significantly influenced by both complete resection (p = 0.04) and age (p = 0.03) on MVA. In astrocytomas, PFS was 42%, 29%, and 15% at 5, 10, and 15 years, and was significantly influenced by POXRT in low- and intermediate-grade tumors on MVA (p = 0.02). OS at 5, 10, and 15 years was 59%, 53%, and 32%, respectively, and was significantly influenced by grade on MVA (p < 0.01). CONCLUSION: Postoperative radiation therapy reduced disease progression in low- and moderate-grade astrocytomas. In ependymomas, complete resection significantly influenced OS.
Assuntos
Glioma/radioterapia , Neoplasias da Medula Espinal/radioterapia , Adolescente , Adulto , Idoso , Análise de Variância , Astrocitoma/mortalidade , Astrocitoma/radioterapia , Astrocitoma/cirurgia , Criança , Pré-Escolar , Progressão da Doença , Ependimoma/mortalidade , Ependimoma/radioterapia , Ependimoma/cirurgia , Feminino , Glioma/mortalidade , Glioma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Neoplasias da Medula Espinal/mortalidade , Neoplasias da Medula Espinal/cirurgia , Análise de SobrevidaRESUMO
Between 2000 and 2002, the Association of Residents in Radiation Oncology (ARRO) conducted its 18th, 19th, and 20th annual surveys of all residents training in radiation oncology in the United States. This report summarizes these results. The demographic characteristics of residents in training between 2000 and 2002 are detailed, as are issues regarding the quality of training and career choices of residents entering practice.