Therapeutic Effects In Patients Receiving Microsurgery And Postoperative Intensity-modulated Radiotherapy And Chemotherapy For High Grade Gliomas

Objectives:Surgery and chemoradiotherapy is the standard treatment for high-grade glioma,postoperative radiotherapy can reduce tumor recurrence and improve patient survival.In this study,we retrospectively analyzed the survival of 106 high-grade glioma patients including patients who received post-operative intensity-modulated radiotherapy(IMRT)and recieved only microsurgery in the first Hospital of Zhejiang university,we evaluated the local tumor control and survival of post-operative IMRT in high-grade glioma.MethodsThe 106 patients with high-grade glioma who had been initially treated and pathologically confirmed in our hospital from January 2015 to December 2017 were enrolled.The information of patients' age,gender,tumour size,tumour pathology,tumour location,epilepsy or not,prescription radiation dose,chemotherapy and tumor recurrence time and patients survival time were collected.The overall survival and progression-free survival of high-grade gliomas receiving or not receiving post-operative IMRT and chemotherapy were observed and comparedResults98 high grade glioma patients with 62 cases who received standard post-operative IMRT and chemotherapy,and another 36 cases only received microsurgery for various reasons were enrolled in this study.The median follow-up time was 14 months for all the patients.In post-operative IMRT and chemotherapy group,the median survival time was 16 months,1-year survival rate was 68.7%,and 2-year survival rate was 37.7%.1-year progression-free survival rate was 61.3%,and 2-year progression-free survival rate was 30%.The median progression-free time was 14 months.In microsurgery alone group,the median survival time was 10 months,1-year survival rate was 56.3%,and 2-year survival rate was 25%.1-year progression-free survival rate was 40%,and 2-year progression-free survival rate was 15%.The median progression-free time was 8 months.There were significant differences in overall survival and progression-free survival between two groups(P 0.01 and 0.021,respectively).Moreover,the use of microsurgery plus IMRT radiotherapy and chemotherapy in this study had a better survival than standard treatment reported in the literature.ConclusionsMicrosurgery and IMRT was an effective therapy for high-grade glioma patients,had a better tumor local control and overall survival.It is expected to become the standard local treatment method for high grade glioma in the future.