MODIFIED CHEMORADIOTHERAPY FOR HIGH-GRADE GLIAL BRAIN TUMORS
Objective. Evaluating of the long-term outcomes of multimodality treatment of patients with high-grade (III-IV) brain gliomas using modified chemoradiotherapy with temozolomide depending on the tumor pathology and on the prognostic factors capable of affecting treatment outcomes was the purpose of the study. Materials and methods. The retrospective clinical study enrolled 308 patients who had undergone surgical treatment in 2002-2013 with established pathological diagnosis of high-grade glial brain tumor. In the postoperative period 155 (50.3%) patients were administered radiotherapy and 153 (49.7%) received modified chemoradiotherapy with temozolomide. There was no statistically significant difference between the compared groups in prognostic factors capable of affecting the treatment outcomes. Results. The modified chemoradiotherapy with temozolomide compared with radiotherapy alone provides a statistically significant improvement in 5-year overall survival of patients with anaplastic oligoastrocytomas and oligodendrogliomas (grade III) (from 36.4±14.5% to 85.7±13.2%, P=0.035) as well as the median and 5-yearoverall survivals of patients with anaplastic astrocytomas (grade III) (from 15 months and 19.5±9.6% to 37 months and 35.7±13.0% respectively, P=0.034) with progression-free median survival increasing from 7 months to 24 months (P=0.001), the median and 5-year overall survivals of patients with glioblastoma (grade IV) - from 12months and 8.3±2.5% to 16 months and9.5±3.0% respectively (P=0.009), and median progression-free survival - from 8 months to 10 months (P=0.036).