Results of multicomponent treatment of patients with progression of primary brain glioma

The aim of this study was to determine the most effective approach to the treatment of patients with continuous growth of brain glioma. Material and Methods. The study included 200 patients with progression of primary brain glioma, who were treated at the Chelyabinsk Regional Center of Oncology and Nuclear Medicine in the period from 2001 to 2021. The average age of patients was 47.86 ± 11.47 years. The ratio of men to women was 1:1. The continuous growth of high-grade glioma was detected in 125 cases. The progression of low-grade glioma was observed in 40 patients. Transformation of low-grade glioma into high-grade glioma was found in 35 patients. Re-surgery was performed in 92 patients. Repeated radiation therapy was given to 140 patients. Chemotherapy as the method of choice was administered to 60 patients. Results. The median overall survival (OS) time was 36 months. The 1- and 2-year survival rates were 96.0 % and 59.4 %, respectively. The method-specific overall survival time was 15 months. There was a tendency towards an increase in OS in all subgroups of patients who underwent re-surgery. The highest method-specific overall survival rates were observed in patients who received stereotactic radiation therapy (STRT) and combined photon-neutron therapy (CPNT): 23 and 47 months in patients with high-grade glioma and 60 and 72 months in patients with continuous growth of low-grade glioma, respectively (p>0.05). In patients with the transformation of low-grade glioma into high-grade glioma, the method-specific OS was higher in patients who received combination of chemotherapy and radiation therapy compared to those who received chemotherapy or radiation therapy alone: 32, 12, and 24 months, respectively (p>0.05). Conclusion. Repeated surgery is the optimal treatment approach for patients with continuous growth of primary brain glioma. In cases with repeated radiotherapy courses, CPNT or STRT can be the methods of choice. Treatment of patients with transformation of low-grade gliomas into high-grade gliomas should include repeated course of chemoradiotherapy.