Choice of fractionation regimen for treatment of high-grade gliomas (part 1): age and tumor grade

Based on the treatment outcomes of 396 patients with histologically verified grade 3-4 gliomas, the indications for conventional and medium fractionation regimens have been devised. The standard fractionation regimen with a single dose of 2 Gy is recommended for elderly patients aged 60 years or more with grade 3 gliomas. Increase in the total tumor dose up to 60-62 Gy for grade 4 gliomas and to 54-56 Gy for grade 3 gliomas is an important factor for improving the overall survival rate. The medium fractionation regimen with a single dose of 3 Gy is preferred for patients younger than 60 years. The use of a total tumor dose of 45 Gy and more seems to be reasonable.