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Final report from intergroup NCCTG 86-72-51 (Alliance): a phase 3 randomized clinical trial of high dose versus low dose radiation for adult low-grade glioma.

Neuro-oncology 2020 January 31
BACKGROUND: The optimal radiation dose for adult supratentorial low grade glioma is unknown. The aim of this study was to provide a final update on oncologic and cognitive outcomes of high dose versus low dose radiation for low-grade glioma.

METHODS: Between 1986 and 1994, 203 patients with supratentorial low grade glioma were randomized (1:1) to 50.4 Gy in 28 fractions versus 64.8 Gy in 36 fractions after any degree of resection.

RESULTS: For all patients, median OS was 8.4 years (95% CI: 7.2 - 10.8). Median progression-free survival (PFS) was 5.2 years (95% CI: 4.3 - 6.6). Median follow-up is 17.2 years for the 33 patients still alive.

CONCLUSIONS: Long-term follow-up indicates no benefit to high-dose over low-dose radiation for low-grade gliomas. Cognitive function appeared to be stable after radiation as measured by MMSE.

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