Surgery followed by irradiation in glioblastoma multiforme. A report of 28 cases

Abstract

Treatment results in glioblastoma multiforme, irrespective of the management, are poor. Median survival in patients managed with surgery alone is 4 months and in those treated with surgery and adjuvant radiotherpy -9 months.

Twenty eight patients with glioblastoma multiforme were treated at the Department of Oncology and Radiotherapy, Medical University of Gdańsk between 1991 to 1995. There were females and 20 males and the median age was 58 years (range 18 to 75 years). In 22 cases (78%) diagnosis was confirmed by histology, and in the remaining six cases biopsy was not taken due to the deep localization of the tumour; in all these patients diagnosis was based on CT imaging. All patients were irradiated with cobalt unit and received conventional radiotherapy, 5 days a week, 1.8 Gy per fraction. The first part of treatment included whole brain irradiation (40 Gy) delivered through lateral parallel opposed fields. Thereafter in all instances a brain CT was done and in case of regression or stabilisation (23 pts), a boost dose of 15–22 Gy with reduced portals was delivered. Total dose delivered to the tumor bed was 55–62 Gy. Radiotherapy tolerance was satisfactory and there were no serious complications and interruptions of treatment.

Median local recurrence-free survival was 5.3 months, and a median survival – 9.9 months (range, 1.6 to 31.2 months). There was no correlation between survival and radiotherapy dose, sex, pretreatment WHO performance status and tumor localization.

Our results confirm poor prognosis in glioblastoma multitorme. New more effective therapeutic approaches are sorely needed in this tumour.