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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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For all patients, median overall survival (OS) was 8.4 years (95% CI: 7.2\u201310.8). Median progression-free survival (PFS) was 5.2 years (95% CI: 4.3\u20136.6). Median follow-up is 17.2 years for the 33 patients still alive. High-dose radiation did not improve 15-year OS (22.4%) versus low-dose radiation (24.9%, log-rank P\u2005=\u20050.978) or 15-year PFS (high dose, 15.2% vs low dose, 9.5%; P\u2005=\u20050.7142). OS was significantly better for patients with preoperative tumor diameter &amp;lt;5 cm and baseline Mini-Mental State Examination (MMSE) &amp;gt;27 and who underwent gross total resection. PFS was improved for patients with oligodendroglioma versus astrocytoma, preoperative tumor diameter &amp;lt;5 cm, patients who had gross total resection, and patients with baseline MMSE &amp;gt;27. For patients who had normal MMSE at baseline, at 7 years only 1 patient (5%) had a clinically significant decrease in MMSE from the previous time point, with the remainder (95%) stable. None had decrease in MMSE at 10, 12, or 15 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1093\/neuonc\/noaa021","type":"journal-article","created":{"date-parts":[[2020,1,28]],"date-time":"2020-01-28T04:21:24Z","timestamp":1580185284000},"page":"830-837","source":"Crossref","is-referenced-by-count":43,"title":["Final report from Intergroup NCCTG 86-72-51 (Alliance): a phase III randomized clinical trial of high-dose versus low-dose radiation for adult low-grade glioma"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8039-2398","authenticated-orcid":false,"given":"William G","family":"Breen","sequence":"first","affiliation":[{"name":"Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S Keith","family":"Anderson","sequence":"first","affiliation":[{"name":"Alliance Statistics and Data Center, Mayo Clinic, Rochester, 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