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Top Line: Have you ever read a “long-term analysis” of >10 year outcomes after cancer treatment and been like...ok this is a bit overkill.
The Study: Not so when it comes to low grade gliomas (LGG). That’s because median survival for these patients approaches a decade. We’re here to bring you reeeeeally long term outcomes of the Intergroup trial that kickstarted in 1986 with enrollment of patients with low-grade gliomas (mixed bag) receiving post-op radiation to 50.4 Gy versus 64.8 Gy, both in 1.8 Gy fractions. And if you're familiar with how we treat LGG today you won’t be surprised that the higher-dose bought patients little more than greater toxicity—consistent with the concurrently run “believers trial.” Also recall this far predates RTOG 9802 so no one received chemo. We now have results that are so long-term the authors were emboldened to deem this the “final report.” Of 203 enrollees, 33 were still alive...partly because a lot can happen in three decades. The good news is that among these (very!) long-term survivors, there was no sign of late-onset decline in mini-mental status over time following radiation: of 20 patients with normal cognitive testing at baseline, 19 still remained without decline in scoring. More promising is that, overall, those with low baseline scores were more likely to improve than decline after radiation.
TBL: Signs point to more improvement than decline in mental status following post-op radiation for low-grade glioma, even when following patients through the decades. | Breen, Neuro Oncol 2020