Treatment outcome of Brain Astrocytoma

Astrocytoma is the most common primary brain tumor, which comprises a wide range of neoplasms with different clinical courses. This study was performed to determine some epidemiological and clinical characteristics and treatment results of patients with astrocytoma. Some presumed prognostic factors were also evaluated. In this descriptive study we evaluated 324 patients with histological proven brain Astrocytoma who were treated in Qaem and Omid hospitals, Mashhad, between April 1991 and April 2001. Information regarding individual characteristics, age. Sex, clinical presentation, type of treatment and surgry, side effects, imaging finding, histological grad and follow up were collected. WHO classification was used for the uniforming of histological reports. The collected information were analyzed using chi-square and Kaplan-Meier tests and SPSS software. 189 male and 135 female patients entered the study. There were 31 cases with grade I, 118 with grade II, 54 with grade III and 121 cases with grade IV astrocytoma. The median age for low grade and high-grade astrocytomas was 25 and 45 years respectively. The 3-year survival rate for grade I to IV was 94.7%, 74.9%, 52.7% and 6.7% respectively. In rnultivariate analysis, for low grade astrocytomas, grade II, age > 50 and biopsy only and for high grade astrocytomas, grade IV and biopsy only were associated with adverse prognosis. The survival rate for grade I astrocytomas is excellent and for grade II astrocytomas is satisfactory. But high grade astrocytomas especially gelioblastoma multiform, have dismal prognosis. For both low and high-grade astrocytomas, tumor grade and extent of surgery had significant impact on prognosis. Age over 50 was associated with adverse prognosis for low-grade astrocytomas