Radiotherapy of high grade cerebral gliomas: Results and prognostic factors

ABSTRACT

A retrospective survey of the records of forty-six patients with histologically verified high grade cerebral gliomas [14 grade III and 32 grade IV]; who were referred for treatment to Jeddah Cancer Center between November '86 and ecember '89 inclusive was carried out. They were 34 males and 12 females with a mean age of 43.87 [ +/- 17.08 years for the whole group. A significant beneft was obtained by postoperative radiotherapy. The mean survival time was 18.25 [ +/- 27.94] weeks without irradiation versus 76.1 [ +/- 33.33] weeks irradiation [P< 0.01]; extent of surgical resection [118.5 +/- 46.52 weeks for gross total excision vs 79 /- 49.34 weeks for subtotal excision [P< 0.05] and 75 +/- 38.81 weeks for biopsy only [P< 0.05]; total radiation dose to the tumour bed [109.29 +/- 37.02 weeks for a total dose > 60 Gy vs 41.9 +/- 35.4 weeks for a dose < 30 Gy [P< 0.01] and 77.13 +/- 30.59 weeks for a dose < 60 Gy [P< 0.01]; postoperative performance status [118.35 +/- 38.44] weeks for a scale of < 100 vs 72.3 +/- 41.1 weeks for a rate of < 80 [P< 0.01] and 50.12 +/- 29.65 for an index of < 60 [P< 0.01] as well as age at presentation [101.11 +/- 47.41 weeks for an age < 40 years vs 67.1 +/- 41.03 weeks for an age > 40 years [P< 0.01]. The mean survival time for the whole group was 81.13 +/- 46.46 weeks. By multivariate analysis, the most powerful factors affecting survival in order of importance were found to be total radiation dose, performance status, extent of surgery and tumour grade. In the design of prospective randomized studies, it would be better to stratify patients according to these prognostic variables