Evaluation of the effectiveness of multicomponent treatment in the progression of primary low-grade brain gliomas. Own experience.

Abstract

The purpose of the study: to determine the most important prognostic factors, as well as the most effective treatment option in patients with continued growth of primary low-grade gliomas of the brain. Materials and Methods: This study included 40 patients with a confirmed diagnosis of progression of low-malignant glial brain tumors, who underwent inpatient treatment at the Chelyabinsk oncology center from 2007 to 2022. The ratio of men and women: 1:1.5. The mean age was 45.6 11.5 years. Patients with grade I astrocytomas predominated (n=23), oligodendroglioma was diagnosed in 8 patients. Reoperation was performed in 11 patients as the first stage of progression treatment. In 7 cases, monochemotherapy with temozolomide was performed. Repeated radiation therapy was performed in 29 patients, of which: 9 patients received a course of combined photon-neutron therapy ; 9 people stereotactic radiation therapy was performed on the CyberKnife device; in 11 cases - external beam radiation therapy . Results: The median overall survival (OS) for all patients with continued growth of low-grade cerebral gliomas after treatment was 120 months. 1-year OS - 97.3%; 3-year-old - 86.8%; 5-year-old - 78.2%. Median OS after relapse treatment was 36 months. The median OS was higher in the age group under 50 compared to the older age group: 120 and 95 months. (p0.05). The best results of treatment were noted in patients who underwent reoperation followed by a course of radiation therapy or chemotherapy with temozolomide for 48 months. and 36 months. respectively (p0.05). When analyzing the results of treatment after a course of repeated radiation therapy in an independent variant, there were undoubted advantages in patients who underwent stereotactic radiation therapy and photon-neutron therapy for 60 months. and 34 months. (p0.05). Conclusion: Thus, the optimal approach to the treatment of patients with continued growth of primary low-grade glioma brain tumors is to perform a second operation, followed by radiation therapy or chemotherapy. The method of choice for a repeat course of radiotherapy may be photon-neutron therapy or a course of stereotactic radiation therapy. Key words: recurrent , astrocytoma, temozolomide, stereotactic radiation therapy