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Abstract
Purpose: to present the first results of a randomized study of two various radiotherapy fractionation schemes in glioblastoma (GBM)
Material and methods: Patients with GBM in subgroups older and younger than 50 years were alternately used a radiation therapy regimen with a prescribed dose of 2 and 3 Gy (research involving paired selection strategy). After recruiting 120 patients, a predictor of continued growth was included in the study design after microsurgical intervention. In total, the study included 70 patients treated with the prescribed dose of 2 and 3 Gy. Continued growth after microsurgical intervention was diagnosed in 60 patients, there was no growth in 80 patients.
Results: In general, as of December 2021, a recurrence was recorded in 105 patients out of 140 (75%): 62 patients were diagnosed with central recurrence (44.3%), 28 with marginal localization (20%) and in 15 had a distant form of growth as the first manifestation of glioma progression (10.7%). The predictors of local progression were continued growth after microsurgical intervention (OR=1,916; p=0,003), the use of temozolomide in conjunction with radiation therapy (OR=0,502; p=0,002) and homogeneity index level over 8.5 (OR=0,535; p=0,009) was significant. The radiotherapy fractionation schemes plays a definite role, the 3 Gy regimen improves the results according to the criterion of local recurrence (OR=0,620; p=0,022).
Conclusion: patients with and without continued growth after microsurgical intervention belong to different prognostic groups, the results of treatment in them should be considered separately. The first data from the randomized study show that the radial therapy regimen with the prescribed dose of 3 Gy is as good as the standard program in terms of primary and local progression.
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