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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2017; 38(04): 495-501
DOI: 10.4103/ijmpo.ijmpo_200_16
Original Article

Modulated Radiotherapy with Concurrent and Adjuvant Temozolomide for Anaplastic Gliomas: Indian Single‑center Data

Tejinder Kataria
Division of Radiation Oncology, Medanta The Medicity, Gurgaon, Haryana, India
,
Trinanjan Basu
Division of Radiation Oncology, Medanta The Medicity, Gurgaon, Haryana, India
,
Deepak Gupta
Division of Radiation Oncology, Medanta The Medicity, Gurgaon, Haryana, India
,
Shikha Goyal
Division of Radiation Oncology, Medanta The Medicity, Gurgaon, Haryana, India
,
Shahida Nasreen
Division of Radiation Oncology, Medanta The Medicity, Gurgaon, Haryana, India
,
Shyam S Bisht
Division of Radiation Oncology, Medanta The Medicity, Gurgaon, Haryana, India
,
Ashu Abhishek
Division of Radiation Oncology, Medanta The Medicity, Gurgaon, Haryana, India
,
Susovan Banerjee
Division of Radiation Oncology, Medanta The Medicity, Gurgaon, Haryana, India
,
Kushal Narang
Division of Radiation Oncology, Medanta The Medicity, Gurgaon, Haryana, India
,
Ajaya N Jha
Division of Neurosurgery, Medanta The Medicity, Gurgaon, Haryana, India
,
Ishani Mohapatra
Department of Pathology, Medanta The Medicity, Gurgaon, Haryana, India
,
Jayesh A Modi
Department of Radiology and Imaging, Medanta The Medicity, Gurgaon, Haryana, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Objective: To evaluate early clinical outcome for anaplastic gliomas (AG) treated in the era of modulated radiotherapy (RT) and concurrent plus adjuvant temozolomide (TMZ) in an Indian setting. Materials and Methods: Fifty-three patients with AGs treated with modulated RT and concurrent (95%) and adjuvant TMZ (90%) were analyzed. About 80% of patients had Karnofsky performance status (KPS) at least 90 with 30% seizure at presentation. Postoperative magnetic resonance imaging was available in 65% cases and RT dose was 60 Gy in 30 fractions. First posttreatment imaging was performed at 1 month and then at 3 and 6 months post-RT and then every 3 months. Kaplan–Meier analysis was used to estimate disease-free survival (DFS) and overall survival (OS), and analysis was done using SPSS version 18.0. Results: With median follow-up of 25 months, 2-year DFS and OS were 75% and 88%. There were only 5% symptomatic central nerves system and 8% symptomatic hematological toxicities. At the 1st evaluation, 30.4% hadcomplete response (CR), at 3 months 40%, and at 6 months 43%. At 6 months, only 4% had progressive disease. Forty-six patients were evaluable till the last follow-up with and 55% had stable to CR. On univariate analysis for DFS, KPS at presentation >90 (P = 0.001) and response at 6 months (P = 0.02) were significant and for OS KPS at presentation (P = 0.004) alone. Conclusion: Modulated RT with TMZ among Grade III glioma patients resulted in minimum treatment-related toxicities and encouraging survival. Molecular prognostic markers will determine most favorable groups in future.

Keywords

Anaplastic glioma - modulated radiotherapy - survival - temozolomide


Publication History

Article published online:
04 July 2021

© 2017. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used forcommercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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