HIGH GRADE GLIOMA OF CENTRAL NERVOUS SYSTEM: SINGLE CENTER TREATMENT EXPERIENCE

Abstract

Objective: To evaluate characteristics and treatment responses of patients with high grade gliomas (HGG) in our center. Medical files of patients with malignant CNS tumors between 1987-2020 were analyzed retrospectively. There were 44 patients with HGG. Case report: Diagnosis of patients as follows: 21 pons glioma, 2 anaplastic astrocytoma, 11 anaplastic ependimoma, 7 glioblastoma multiforme, 1 glioblastoma, 2 gliomatosis cerebri. The median age at diagnosis was 6,5 yrs (7 – 17 yrs), M/F:25/19. Age distribution: <5 yrs 12 patients, 5-10 yrs 18 patients, 10-18 yrs 14 patients. The most frequent complaints for pons gliomas: cranial nerve paralysis (52%), visual impairment (48%), headache (38%), power loss (43%) and speech disorder (30%). Methodology: Surgery was performed to extrinsic component of mass in 3 patients of pons gliomas.For other HGG: 7 subtotal resection and 16 gross total resection had performed.7 patients died before RT. And other 37 patients received radiotherapy. RT total doses varied between 50-60 Gy.7 patients were not received chemotherapy, 3 of them died before chemo, and others received only RT. For other HGGs, platin based regimens used for the first line treatment. Temozolamide, bevacizumab, irinotecan as the other options. Results: Median progression free survival time was 6 mos (2weeks-25 mos) for pons gliomas, for other gliomas median progression free survival time was 14 mos(0 -74 mos).For pons gliomas: Event free survival rate for 6 mos was 75%, for one year 17%;one year, 18 mos, and two years overall survival rates were 84%,52% and 10%respectively.For other HGGs: Event free survival rate for one year and two years were 57% and 17% respectively. One year and two years overall survival rates were 73% and 36% respectively. Conclusion: High grade glioma is a group of tumors in which still the helplessness experienced in treatment. Despite radiotherapy and chemotherapy, prognosis is very poor. The progression free and overall survival rates of patients were similar to literature. With new developments in molecular pathology, as the use of molecular target therapies, the progression free survival rates newly will improve.