Treatment Outcome of Supratentorial High Grade Astrocytoma and Glioblastoma Multiform

Purpose: The study was initiated to obtain epidemiologic data and information on anatomic distribution, clinical features and treatment results in patients with primary supratentorial anaplastic astrocytoma and glioblastoma multiform. Patients and Methods: Between January 2000 and January 2006, 113 primary high grade astrocytoma patients were eligible to evaluate clinical features. Radiotherapy was received by all patients whether gross total tumor excision had been carried out or not. External beam radiation therapy was delivered at 2Gy once daily to the intracranial lesion and surrounding oedema with 2-3cm safety margin all around with a dose of 4000cGy/20 fraction in 4 weeks, followed immediately by a booster localized field to intracranial bed proper to a dose of 2000cGy/10 fraction in 2 weeks using 60 Co photons. Results: A total of 58.4 patients had anaplastic astrocytoma and 41.6 of the cases, had glioblasloma multiform. The most common site of origin was the temproparietal region (31.8%). Large tumors ( >!5cm) accounted for the majority (75.2%). Seventy one percent of primary high grade astrocytoma patients had a duration of symptoms of !9 3 months. Most primary supratentorial anaplastic astrocytoma and glioblastoma multiform patients had objective radiological response (52.13%) to treatment. Among all our patients, sex, performance status, duration of symptoms, histologic grade, tumor size and extent of surgery were significant prognostic factors for OS. Conclusion: High grade astrocytoma is heterogeneous disease. Histopathology of the tumor, sex, performance status, tumor size, duration of symptoms and extent of surgery were the most important significant prognostic factors. The number of patients with high grade astrocytoma did not allow for detailed analysis. Large studies are needed for primary supratentorial anaplastic astrocytoma and glioblastoma multiform with new treatment modalities to improve survival in these patients.