Abstract BACKGROUND The current standard of care for newly diagnosed high-grade glioma (HGG) is safe surgical resection followed by Radiotherapy (RT) with concurrent Temozolomide (TMZ) followed by adjuvant TMZ for 6 cycles. This retrospective study evaluates survival for patients with HGG treated according to this schema at our institute. MATERIAL AND METHODS Medical records of 246 patients with histologically confirmed HGG who underwent surgery followed by radiotheray with concurrent and adjuvant chemotherapy from 2011 to 2023 were retrospectively reviewed, and their clinicopathological characteristics and survival outcomes were analysed. Thirty-three patients had near total resection,189 had subtotal resection and 24 had biopsy only. 171 (70%) patients were treated with VMAT, 60 (24%) patients were treated with IMRT and 15 (6%) received 3DCRT treatment. Overall survival (OS) and progression-free survival (PFS) were estimated using Kaplan-Meier survival analysis with log-rank testing. RESULTS A total of 246 patients with HGG were analysed in this study including, 105 grade III glioma and 141 grade IV glioma. At a median follow-up period of 21 months (range; 1-160 months), the median OS for HGG was 37 months, but median OS for grade IV and grade III gliomas was 17 and 88 months, respectively. The estimated OS at 5-year was 14.2% for grade IV glioma, 59.4% for anaplastic astrocytoma and 67.3% for anaplastic oligodendroglioma. Similarly, the 5-year PFS rates was 10.6% for grade IV glioma, 56.3% for anaplastic astrocytoma and 58.6% for anaplastic oligodendroglioma. Toxicity was mostly grade 1/2 thrombocytopenia or neutropenia. CONCLUSION The prognosis of high-grade glioma remains dismal, especially for grade IV glioma. Although the current standard of care for high grade glioma is adjuvant radiotherapy and chemotherapy after maximal safe resection, an individualised treatment approach should be considered to improve survival outcomes.
Venkataramana et al. (Wed,) studied this question.