Journal
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
Volume 59, Issue 1, Pages 117-125Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ijrobp.2003.10.040
Keywords
glioma; multivariate analysis; mini-mental state examination; prognosis; radiotherapy
Funding
- NCI NIH HHS [CA-35415, CA-25224, CA-15083, CA-37404] Funding Source: Medline
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Purpose: The outcome and cognitive performance data collected in a prospective, intergroup clinical trial were analyzed to assess the prognostic importance of the baseline (before radiotherapy) Mini-Mental State Examination (MMSE) score in patients with low-grade glioma. Methods and Materials: The patients studied were 203 adults with a supratentorial low-grade glioma randomly assigned to low-dose (50.4 Gy in 28 fractions) or high-dose (64.8 Gy in 36 fractions) localized radiotherapy. Folstein MMSE scores and neurologic function scores at baseline in combination with multiple other baseline variables were analyzed. The median follow-up was 7.4 years for the 101 patients still alive. Results: Patients (n = 36) with an abnormal baseline MMSE score (less than or equal to26) had a worse 5-year progression-free survival rate (27% vs. 60%; p < 0.001) and overall survival rate (31% vs. 76%; p < 0.001) compared with those with a normal score. On multivariate analysis, the baseline MMSE score was a statistically significant predictor of survival. Other factors associated with overall survival were age, tumor size, and tumor histologic type. Conclusion: The presence of an abnormal baseline MMSE score was a strong predictor of poorer progression-free and overall survival for patients with a low-grade glioma. The baseline MMSE should be considered in future prognostic scoring systems. (C) 2004 Elsevier Inc.
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