Therapeutic Effects And Quality Of Life In Patients Receiving Postoperative Intensity-modulated Radiotherapy For Gliomas

Objectives:Intensity-modulated radiotherapy (IMRT) has emerged as an advanced radiation technique that spares the critical structures while maximally delivering prescription dose to the target volume. It has shown encouraging results in decreasing local recurrence and reducing radiation toxicities and improving the quality of life (QoL) in patients with head and neck cancers and neoplasms of other sites. Expecting to bring similar benefits to glioma patients using IMRT, we did a retrospective study to report the local control and QoL in 63 glioma patients receiving postoperative IMRT in our institute. The objective of this study is to evaluate local control of tumour and quality of life (QOL) in glioma patients treated with IMRT. and to explore the possible clinical factors affecting QoLMethodsAll patients were consecutively admitted in our hospital from October 2007 to August 2010 with pathological diagnosis for glioma. The information of patients'age, gender, Karnofsky score, tumour size, tumour pathology, tumour location, prescription radiation dose and survival time were collected. The half-year and one-year survival time and progression time were calculated. Neurotoxicity observation designed to score symptoms according to the National Cancer Institute Common Toxicity Criteria (version 3.0) for late effects on normal central nervous system including Karnofsky scores, fatigue, headache, sleepiness, cognitive disability, memory decline, personality and behavior change, language deficits, sensory abnormalities, motor abnormalities and seizures. Chi-square analysis was used to explore the main clinical factor affecting neurotoxicityResultsSixty-three patients with 39 high grade gliomas and 24 low grade gliomas were enrolled in this study. The median follow-up time was 13 months, ranged from 6 to 34 months, with 13 recurrence and 7 deaths. The median progression free survival time was 12 months, with 100% half-year and 82.8% one-year survival rate,88.9% half-year and 68.6% one-year progression free survival rate, respectively. The main complaints after postoperative IMRT were fatigue and mild memory decline or cognitive disabilities, age was the main factor that influence fatigue, memory decline and cognitive disabilities. In addition, total prescription radiation dose was another factor which affecting memory decline, and temozolomide concurrent chemotherapy increase the incidence of fatigue symptom.ConclusionsPostoperative IMRT was an effective and safe modality of therapy for glioma patients. It is an advisable option for IMRT to use in glioma patients for the purpose of not only improved tumor control but also well-maintained QoL, but still require larger prospective study which can further prove the value of this technique in glioma.