The effect of waiting for radiotherapy for grade III/IV gliomas

Radiother Oncol. 2000 Nov;57(2):131-6. doi: 10.1016/s0167-8140(00)00257-7.


Aim: To determine the effect of waiting time for radiotherapy on the overall survival of patients with high-grade gliomas.

Methods: We examined records of patients with grade III/IV gliomas who were referred to radiotherapy after surgery or biopsy - ECOG <3, any age, radical intent or palliative intent with dose >50 Gy, no interstitial or radiosurgery boost. Waiting time was defined in two ways, time from biopsy to radiotherapy and time from presentation to radiotherapy department to start of radiotherapy.

Results: There were 182 patients in the study having a median survival of 8.5 months, with a median follow up of 10.5 months. The group comprised of 63 (35%) grade III and 119 (65%) grade IV gliomas. Median times and ranges from biopsy and presentation to treatment were 26 days (4-78 days) and 15 days (1-62 days), respectively. The median dose was 60 Gy in a median of 30 fractions over a median of 46 days. Tumour progression before and during radiotherapy occurred in seven patients (4%) and 19 patients (11%), respectively. One hundred and seventy-nine patients died of disease. The seven patients whose tumour progressed before radiotherapy were excluded from the analysis of prognostic variables. In a multivariate analysis the variables that were significantly associated with worse survival were older age, reduced dose and prolonged waiting time from presentation. The risk of death increased by 2% for each day of waiting for radiotherapy.

Conclusion: The study showed longer waiting time from presentation at radiotherapy department to treatment to be a significant predictor of overall survival for patients with high-grade glioma.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Brachytherapy / methods*
  • Brain Neoplasms / mortality*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / radiotherapy*
  • Brain Neoplasms / surgery
  • Female
  • Glioma / mortality*
  • Glioma / pathology
  • Glioma / radiotherapy*
  • Glioma / surgery
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Palliative Care / methods*
  • Prognosis
  • Radiation Dosage
  • Sex Distribution
  • Survival Analysis
  • Time Factors