Adapted version RPA-classification in treatment program of brain tumors grade 3-4 (part 2)

In a pilot study of 396 patients with verified malignant brain tumors grade 3-4 shows the role of the adapted version RPA classification in the development of optimal treatment programs in gliomas: fractionated radiotherapy, chemotherapy with temozolomide, the volume of surgical intervention. The current standard of care remains 60 Gy in 30 fractions for patients with glioblastomas and 54 Gy in 27 fractions - for patients with gliomas grade 3 is preferred in RRA classes I-III (RSCRR), was a significant decrease in survival when using non-radical doses. Hypofractionation delivered in 17 fractions of 3 Gy for patients with glioblastomas and 45 Gy in 15 fractions - for patients with gliomas grade 3 is preferred in RRA classes IV-V (RSCRR), emphasizes the need to take stock of radical doses. Radiotherapy with temozolomide is useful in patients with classes II-IV, pure radiation - in class V. In the group with class I (RSCRR) pure radiation therapy is sufficient. Total removal of the tumor in patients with classes II-III significantly improved survival rates. In patients with class IV-V the volume of surgical intervention does not affect the results of treatment and total tumor removal is impractical. In the group with class I desired maximum volume during surgery. Using the adapted classification of RPA (RSCRR), and the division of patients into RPA-classes will lead to more selective and individual approaches to treatment.