Role of 3D Hypofractionated Radiotherapy in Treatment of High Grade Gliomas: A Prospective Study

摘要

Purpose: To evaluate the efficacy and safety of hypofractionated radiotherapy in treatment of patients with high grade glioma. Patients and Methods: A total of thirty patients with high grade glioma referred to clinical oncology and nuclear medicine department, Zagazig University Hospitals between July 2012 to January 2014. All patients were treated with three dimensional (3D) conformal hypofractionated radiotherapy at a dose of 45 Gy/15f treatments over 3 weeks for cases with gross total excision followed by 9Gy in 3 fractions for cases with subtotal excision and biopsy. Results: The median age was 53 years (range 26-66). The median follow up was 12.23 months (range: 4–22 months). One-year overall survival (OAS) and progression free survival (PFS) rates were 58.9% and 12%, respectively. In univariate analysis, age ≥50 years, poor performance status [Karnofasky score of ≥50–70%]. Grade IV histology, subtotal excision and overall response to treatment was all associated with statistically significant reduction in OAS and PFS rates. Multivariate analysis, showed that age 70 were the only independent prognostic factors that were associated with good OAS (p= 0.010 and p= 0.015, respectively), and grade III and overall response were the only prognostic factors associated with good PFS (p= 0.002 and p=0.014, respectively). There were minimal side effects to radiation therapy, and all patients complete treatment time without interruption. Conclusion: Conformal hypo fractionated radiotherapy is effective and well tolerated for patients with high grade glioma.