RT-15IMPACT OF CHANGING TRENDS OF TREATMENT ON OUTCOME OF GLIOSARCOMA: A TERTIARY CARE CENTER EXPERIENCE

摘要

AIM: To assess the clinicopathological features and outcome in patients of primary gliosarcoma with changing trends of treatment. MATERIALS AND METHODS: Medical records were reviewed over a 5yearsperiod from 2009 to2013 of Gliosarcoma treated in the department. All patients who received 3D-Conformal Radiotherapy (3DCRT) with or without concurrent and adjuvant Temozolomide post surgery were included in the analysis. RESULTS: A total 27 patients were included in this study. Median age of presentation was 54 years (rang9-69 years), male to female ratio was 1.25:1, median KPS at presentation was 70. At presentation all patients had raised intracranial tension with motor symptoms in 48.1%, Memory impairment in 6 patients, Seizures and dimness of vision was seen in 18.5% and 11.1% cases respectively. Most common location of the tumour was temporal lobe (48.1%).About 60% (n = 16) patients underwent Gross total resection. On histopathological examination all patients showed biphasic pattern with glial fibrillary acidic protein positivity for (GFAP) glial component and vimentin positivity for mesenchymal component. Twenty three (80.8%) patients received radical radiotherapy i.e. 60 Gy/30#/6 weeks and 4 patients received hypo-fractionated radiotherapy 40 Gy in 15 fractions in 3 weeks. Eleven (42.3%) patients received Concurrent and adjuvant Temozolomide. Median overall survival of our patients was 9 months. Six months survival in the chemo-radiation arm was 82% as compared to 58% seen in patients who were treated with radiotherapy alone. CONCLUSION: Treating Gliosarcoma is a major therapeutic challenge to a clinician because of its poor prognosis, aggressive clinical behavior, rarity and limited clinical experience. Addition of Temozolomide has shown a better trend in survival though it is statistically not significant