Prediction of treatment results of low-grade gliomas of the cerebral hemispheres.

Abstract

Glial tumors are the most common primary neoplasms of the central nervous system. Their proportion in the total structure of primary brain tumors is 50-65%. In Ukraine, according to the statistical data of the cancer-registry of the year 2014, 49,3% of patients with primary diagnosed malignant neoplasms of the brain did not live for one year. The aim of the study was to improve the survival rates of patients with low-grade glial tumors (LGT) (grade III-IV) by determining optimal treatment strategy and main prognostic survival factors. A prospective study of the results of treatment of patients with LGT from 2009 to 2014 was conducted. The study consistently included 100 operated patients with LGT (anaplastic astrocytoma (AA) and glioblastoma (GLB)). The median survival in the total group of patients (n=100) was 363.5 days (12 months). The main statistically significant prognostic factors of survival were: the completeness of tumor removal (p=0.00000000007) and the character of adjuvant therapy (p=0.000012). With the removal of LGT III-IV grade aplasias, which do not spread to functionally important areas and deep areas of the brain, one should try to perform Gross-total resection (GTR), which ensures long-term survival. The median survival of patients after GTR was 22.3 months. An integrated approach to the treatment which includes surgery, adjuvant radiotherapy and monochemotherapy with temozolamide showed the best survival rates – 20.5 months.

Keywords

• low-grade gliomas
• anaplastic astrocytoma
• glioblastoma
• surgery
• gross-total resection
• adjuvant therapy
• survival
• Kaplan-Meier