I tumori gliali. La nostra esperienza radioterapica

From 1978 to 1992, 135 consecutive patients with high grade glioma were treated at the Radiotherapy Department of Pordenone General Hospital. The patients were divided into 4 group (on the basis of the time of diagnosis): Group I, surgery if feasible followed by radiotherapy to the brain to a total dose of 34 Gy in 4 fractions, VCR (2 mg i.v.) and BCNU (80 mg/m2i.v.) repeated every 6 weeks; Group II, surgery if feasible and radiotherapy with the same schedule as Group I plus VP16 (75 mg/m2 i.v.) every 3 weeks and BCNU(50 mg/m2 i.v.) every 6 weeks; Group III, surgery if feasible and radiotherapy given to the brain to a total dose of 60 Gy in 30 fractions over 6 weeks plus VCR (2 mg i.v.), BCNU (50 mg/m2) and CDDP (15 mg/m2 i.v.) every 6 weeks; Group IV, after surgery when feasible, radiotherapy with the same schedule as Group III plus BCNU (40 mg/m2) and CDDP (40 mg/m2) given for 3 days in continues, simultaneous infusion, every 6 weeks. On April 30, 1996, in Group I, 28 patients had stable disease (SD) and 2 patients had disease progression. The median survival time was 9 months (range 1-18). In Group II there were 22 SDs. The median survival time was 6 months (range 2-16). In Group III there were 29 SDs and 14 partial remissions. The median survival time was 13 months (range 3-112,5+). In Group IV there were 34 SDs and 6 partial remissions. The median survival time was 13,5 months (range 3-92+). In general, the group of patients treated with radical or subtotal surgery and the patients included in neurological classes I and II, with performance status ≤ 70, and younger than 45 years had a longer survival. In our experience, the patients with a diagnosis of grade III and IV glioma included in the Groups III and IV had a longer survival than those in Groups I and II. None of the patients experienced severe toxicity from the treatment.