Effects Of Supratotal Resection Combined With Concurrent Radiotherapy And Chemotherapy On Cognition And Survival Time Of Frontal Lobe Glioblastoma

Objective: After resection of glioblastoma(GBM)multiforme,residual tumor tissue is more likely to recur than other types of tumors,even after gross-total resection(GTR),in the case of frontal lobe GBM.The effect of further resection of the surrounding brain tissue on the cognitive function and survival rate of the patients is not clear.This study was to explore the feasibility of combined radiotherapy and chemotherapy with GBM supratotal resection(SupTR)of frontal lobe from the point of view of cognitive function and survival time.Methods: The clinical data of 20 patients with frontal lobe GBM from 2016 to 2019 in the neurosurgery department of the second Hospital of Hebei Medical University were collected.All patients were divided into(SupTR)group and(GTR)group according to the operation mode and postoperative magnetic field,10 patients in each group.The patients in SupTR group were treated with supratotal resection,and the patients in GTR group were treated with resection along the tumor and peripheral edema zone.The patients in both groups were treated with standard concurrent radiochemotherapy and adjuvant chemotherapy at 2 ~ 3 weeks after operation.The cognitive function,KPS score and survival time were compared between the two groups(P < 0.05 means the difference is statistically significant).Results: 1.Patients in SupTR group had longer progression-free survival(PFS)and total survival(OS)than those in GTR group,and the difference was statistically significant(P < 0.05).2.There was no difference in montreal cognitive assessment scale(MoCA)score between groups 1 day before surgery,10 days after surgery,and 7 days after concurrent chemoradiotherapy(P > 0.05),there was a difference in MoCA evaluation between the two groups 7 days after the end of concurrent chemoradiotherapy and 1 day before the operation(P < 0.05).3.There was no difference in KPS between the two groups before and after comprehensive treatment(P > 0.05).There was no difference in KPS score between the two groups at 7 days after the end of concurrent chemoradiotherapy and 1 day before surgery(P < 0.05).Conclusions: In the treatment of frontal lobe GBM,SupTR combined with concurrent radiotherapy and chemotherapy had longer PFS and OS than GTR combined with concurrent radiotherapy and chemotherapy,and did not aggravate patients' cognitive dysfunction or impair their general self-care ability.