Clinical and Dosimetric Predictors of Acute XXXX During Radiation Therapy and Concurrent @entity2903 for High-Grade @entity11 .

@entity1 @entity2905 @entity1161 @entity11 @entity348 @entity2903 @entity2904
PURPOSE: Acute severe @entity2905 (ASL) frequently develops during @entity1161 ( @entity1161 ) and concurrent @entity2903 ( @entity2904 ) for high-grade @entity11 (HGG) and is associated with decreased survival. The current study was designed to identify potential predictors of ASL, with a focus on actionable @entity1161 -specific dosimetric parameters. METHODS AND MATERIALS: From January 2007 to December 2012, 183 @entity1 with HGG were treated with @entity1161 + @entity2904 and had available data including @entity348 ( @entity348 ) and radiation dose-volume histogram parameters. ASL was defined as @entity348 of <500/ L within the first 3  months from the start of @entity1161 . Stepwise logistic regression analysis was used to determine the most important predictors of ASL. RESULTS: Fifty-three @entity1 (29%) developed ASL. @entity1 with ASL had significantly worse overall survival than those without (median: 12.5 vs 20.2  months, respectively, P<.001). Stepwise logistic regression analysis identified female sex (odds ratio [OR]: 5.30; 95% confidence interval [CI]: 2.46-11.41), older age (OR: 1.05; 95% CI: 1.02-1.09), lower baseline @entity348 (OR: 0.92; 95% CI: 0.87-0.98), and higher brain volume receiving 25 Gy (V25Gy) (OR: 1.03; 95% CI: 1.003-1.05) as the most significant predictors for ASL. Brain V25Gy <56% appeared to be the optimal threshold (OR:  2.36; 95% CI: 1.11-5.01), with an ASL rate of 38% versus 20% above and below this threshold, respectively (P=.006). CONCLUSIONS: Female sex, older age, lower baseline @entity348 , and higher brain V25Gy are significant predictors of ASL during @entity1161 + @entity2904 therapy for HGG. Maintaining the V25Gy of brain below 56% may reduce the risk of ASL.
