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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Radio-chemotherapy improves survival for IDH mutant, 1p/19q non-codeleted secondary high-grade astrocytoma

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  • Tareq A. Juratli - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
  • Kathrin D. Geiger - Institut für Neuropathologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
  • Thomas Pinzer - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
  • Mechthild Krause - Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
  • Tim Lautenschläger - Department of Radiation Oncology, The Ohio State University Medical School, Columbus, Ohio, U.S.A
  • Gabriele Schackert - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden
  • Dietmar Krex - Klinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMI.09.05

doi: 10.3205/15dgnc302, urn:nbn:de:0183-15dgnc3029

Published: June 2, 2015

© 2015 Juratli et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: To evaluate the treatment efficacy in patients with IDH mutant, 1p/19q non-codeleted secondary high-grade astrocytoma (sHGA) WHO grades III/ IV.

Method: Clinical data of 109 sHGA patients grades III/IV, in addition toIDH mutation-, 1p/19q-codeletion- and MGMT-promoter methylation status -- were retrospectively analyzed. Survival data in relation to adjuvant treatment modalities and molecular profiling were performed.

Results: Out of 109 patients, 88 harbored IDH mutations, 30 patients had a 1p/19q-codeletion and 69 patients exhibited a methylated MGMT-promoter status. During follow-up, 62 patients (57%) died. The postsurgical treatment included: RT plus CT (RT-CT; 54.5%), RT alone (19.3%), and CT alone (22.7%). At a median follow-up of 9.8 years, the median overall survival (OS) was 4.3 years (1.9-6.7 years). Patients who received RT-CT had a significantly longer OS compared with those who underwent RT alone (6.4 vs. 1.2 years, HR 0.35, CI 0.32-0.51, p=0.011). After including only IDH mutant 1p/19q non-codeleted sHGA, the Kaplan-Meier curves estimate a significantly improved OS in the RT-CT cohort in comparison to RT cohort (6.4 vs. 1.2 years, HR 2.7, CI 1.1-6.5, p=0.022).

Conclusions: The addition of alkylating-agent chemotherapy to radiation might significantly improve OS in patients with IDH mutant and 1p/19q non-codeleted sHGA.