Clinical features, management and outcomes of high-grade glioma patients in Ramathibodi Hospital

Objective: To identify prognostic factors for survival and evaluate the effect of treatment on survival of patients with high-grade glioma treated at Ramathibodi Hospital. Material and Method: Medical records of patients with diagnosis of high-grade glioma registered in Ramathibodi cancer registry were reviewed. A total of 36 patients were reviewed, only 27 patients were included on survival analysis. Results: Of the 36 patients, the male: female ratio was 1:1. Mean age of diagnosis was 41.86 years (range 18- 71 years). Histological findings were anaplastic glioma (22.20%), glioblastoma multiforme (63.90%) and mixed glioma (13.90%). Of fifteen patients underwent total tumor removal, 17 patients had partial resection and in 4 cases biopsy alone was done. Two third of the patients had received radiotherapy with mean total dose 5,372 cGy. Nine patients also received chemotherapy (6 temozolomide and 3 BCNU). Median follow-up time was 413.2 days. An overall survival time was 604.04 days and median disease free survival time was 402.45 days. In univariated analysis, the following favorable prognostic factors were identified: histological findings of glioblastoma multiforme (GBM) and mixed glioma, received radiotherapy. In multivariate analysis, radiotherapy improves overall survival significantly. Re-resection at recurrence did not appear to improve overall survival. Conclusion: Adult high-grade glioma had poor prognosis despite aggressive treatment. Radiotherapy significantly improved survival while surgical tumor removal and chemotherapy did not. However due to the small number of patients the further studies should be performed.