The role of functional status and recursive partition analysis (RPA) classes for the choice of fractionation regimen in patients with high-grade gliomas

The treatment results of 396 patients with morphologically verified grade 3-4 malignant brain tumors receiving conventional irradiation regimen and irradiation by medium-sized fractions were analyzed to form institutional guidelines.The standard mode of fractionation with a single dose of 2 Gy and t...

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Bibliographic Details
Published inVoprosy onkologij Vol. 58; no. 3; p. 369
Main Authors Izmaĭlov, T R, Pan'shin, G A, Datsenko, P V
Format Journal Article
LanguageRussian
Published Russia (Federation) 2012
Subjects
Adult
Aged
Brain Neoplasms - pathology
Brain Neoplasms - radiotherapy
Dose Fractionation
Female
Glioma - pathology
Glioma - radiotherapy
Humans
Kaplan-Meier Estimate
Karnofsky Performance Status
Male
Middle Aged
Neoplasm Grading
Predictive Value of Tests
Prognosis
Radiotherapy Planning, Computer-Assisted
Risk Assessment
Risk Factors
Treatment Outcome
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Summary:The treatment results of 396 patients with morphologically verified grade 3-4 malignant brain tumors receiving conventional irradiation regimen and irradiation by medium-sized fractions were analyzed to form institutional guidelines.The standard mode of fractionation with a single dose of 2 Gy and total focal dose (TFD) of 60 Gy is appropriate for patients with initial Karnofsky status of 60-100% and Recursive Partition Analysis (RPA) class I-III. TFD increase to 60-62 Gy in grade 4 gliomas and 54-56 Gy in grade 3 gliomas grants a significant improve in overall survival. An increase of a single irradiation fraction to 3 Gy may be used for patients with initially low functional status (Karnofsky 30-50%) and RPA classes IV-VI. In these cases it is advisable to use the TFD of 45 Gy or more (TFD of equivalent regimen with a dose greater than 54 Gy). The mentioned fractionation regimens could be recommended for the use in clinical practice to improve the results of high-grade gliomas treatment.
ISSN:0507-3758