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- W3094111566 abstract "RTOG 9802 reported an overall survival advantage with the addition of chemotherapy to adjuvant radiotherapy in high-risk low-grade glioma (LGG) patients, with initial results presented in 2012 and published in 2016. In this study, we used the National Cancer Database (NCDB) to measure trends in the use of radiotherapy and chemotherapy in LGG patients from 2010-2016, a period when no published Level 1 evidence existed on the role of trimodality therapy in this population. The NCDB was queried for patients with WHO Grade II glioma treated from 2010-2016 who met the inclusion criteria for treatment with radiotherapy plus chemotherapy on RTOG 9802. Adjusted logistic regression was used to assess the association of treatment year with the annual percentage of patients who received adjuvant radiotherapy and chemotherapy. Relative percent change and average annual percentage change (AAPC) were compared to determine if a significant change (defined a priori as <0.01) occurred in the use of adjuvant therapy in LGG patients during this period. The final analytic cohort consisted of 5,039 patients; 64.3% of patients were ≥40 years of age and 35.7% were <40 years old and had less than gross total resection (GTR). The use of adjuvant radiotherapy and chemotherapy increased from 2013-2016 from 18.9% to 49.7% (p for trend <0.001), with no change observed prior to 2013. The AAPC in the use of trimodality therapy was +39.6% per year (p<0.001). Corresponding declines in patients treated with surgery alone (p<0.001) and surgery plus radiotherapy (p<0.001) were observed during this period. On logistic regression, patients who were <40 years old (Odds Ratio 0.561, 95% CI 0.475-0.663, p<0.001) were significantly less likely to receive adjuvant radiotherapy and chemotherapy than patients ≥40 years of age. In the dataset, 1,042 patients had oligodendroglioma based on 1p19q codeletion status. In this subset, use of adjuvant radiotherapy and chemotherapy increased from 12.5% to 45.1% from 2013-2016 (p for trend<0.001). From 2013-2016, an increasing number of LGG patients were treated with surgery followed by adjuvant radiotherapy and chemotherapy in the absence of Level 1 evidence. Future studies may characterize the use of single agent vs. multiagent chemotherapy in this population and the adoption of trimodality therapy by tumor molecular subtype." @default.
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- W3094111566 date "2020-11-01" @default.
- W3094111566 modified "2023-09-27" @default.
- W3094111566 title "The Use of Adjuvant Radiotherapy and Chemotherapy in Low Grade Glioma Patients in the United States from 2010-2016" @default.
- W3094111566 doi "https://doi.org/10.1016/j.ijrobp.2020.07.2012" @default.
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