|
|
Local control of high-grade gliomas with
limited volume irradiation versus whole brain irradiation
Sharma RR, Singh DP, Pathak A, Khandelwal N, Sehgal CM, Kapoor R, Ghoshal S,
Patel FD, Sharma SC
Department of Radiotherapy and Oncology, Postgraduate Institute
of Medical Education and Research, Chandigarh-160012, India.
Introduction. To evaluate the role of limited field radiation therapy in
the management of high-grade gliomas and glioblastoma multiforme (GBM).
Material and Methods. From July '96 to January '98, 50 newly diagnosed
patients of high-grade gliomas (Grade III and IV) and glioblastoma multiforme
who underwent surgery in the form of partial, sub-total or near-total excision
as the primary treatment were enrolled in this study.
The patients were randomized to receive two different postoperative external
radiation protocols, Study Group A: Localized field external radiotherapy 50
Gy/25#/5 wks followed by Boost 10 Gy/5#/1 wk, Control Group B: Whole brain
external radiotherapy 40 Gy/20#/4 wks followed by Boost 20 Gy/10#/2 wks by
localized field.
Results. 20/25 (80%) patients in the study group and 14/25 (56%)
patients in the control group showed improvement in their Karnofsky Performance
Status (KPS).
Thus a significant difference in the performance status was noted in favor of
limited field irradiation.
No significant difference in the local response was seen between the two groups
after radiotherapy.
Six months progression-free survival of the study group was 44% as compared to
26% in the control group.
Six months overall survival was 66.67% in the study group and 50.72% in the
control group (P<0.01).
Maximum recurrences were noticed within 2 cm of the original tumor margin in
both the groups.
Conclusions. Although local control and survival of the patient in
both the groups were same, performance status definitely improved in patients
treated with localized field irradiation only.
PMID: 14742935 [PubMed - indexed for MEDLINE]
|
